Adventures with the National Health System

It was inevitable. In 2011, none of us ever needed to visit the doctor, as none of ever got sick enough to warrant professional medical care. This time around, we weren't so lucky. As you know, Leah was sick over the weekend, running a fever and covered in some kind of rash. She didn't seem to get any better by Monday, and so we kept her home from school. The rash was worrying me, and I kept checking her tongue to make sure it didn't look like scarlet fever. Finally, I bit the bullet and started to look into how I could take her to a doctor.

St. Andrews has a local hospital, and I pass it every day on the way to Leah's nursery. It's small but always looks very busy, and there's a large pharmacy in front of the building as well. I had a look at the website, and it seemed that there were three general practices at the hospital, called Strathcairn, Feddinch, and Blackfriars. Very Hogwarts! Interestingly, the website implied that new patients register with one of the three practices based on the first letter of their last name. I'm not sure if that's been the practice for some time, or if, when one is registered, one can switch back and forth between the practices. It did seem odd, though of course no stranger than the way we do this in the U.S., where you choose a doctor based on the financial agreements of your insurance carrier. When I explained our particular situation (U.S. residents in the UK for six months, not permanently, affiliated with the university, with a toddler with a fever and a rash) she decided not to transfer me to one of the practices but to have me speak with a nurse at the hospital. She put the phone down, and a nurse was on the other line in about 10 seconds. I repeated all of Leah's symptoms, and she suggested that it was probably just a virus and that I could go to the chemist to have a wee look at her. This seemed like a curious idea, and so I sent David (who comes from a family full of medical doctors and pharmacists) to the Morrison's pharmacy with Leah.

They came back in about 45 minutes with two bottles of medicine and some fruit pouches from the grocery store. David said that when he arrived, the chemist had come around the counter to have a look at Leah and they registered her for the "NHS Minor Ailment Service." He had a pamphlet from the NIH that described this service, and it really sounds brilliant. It's a free service for children (anyone under 16, or 19 if you are still enrolled in school) and those over 60. It provides, through a pharmacist, advice and FREE treatment for a whole list of things, like cough, headache, nasal congestion, sore throat, hay fever, cold sores, indigestion, etc., but also things like acne and head lice. The literature states that it may be the case that the chemist will refer you to a general practitioner, but still...what a great idea this is! What a shame that we don't implement this in the United States! I'm imagining all of the ailments that could be treated by those Rite Aids and Walgreens that are on every street corner in America, rather than in more expensive facilities like the doctor's office, or sometimes even the emergency room. It would really reduce the burden on our medical system, and it would mean that those who can't afford a doctor's visit or an ER trip for a minor ailment could have it taken care of at no expense, before it turns into a larger problem.

Unfortunately, this wasn't the end of our story. Leah seemed better by the evening, and so I went off to my Italian class at the university. As the class let out, I saw a text had come in from Emma saying I should come home because Leah was asking for me. When I got there, she was crying and holding her ear. So, we bundled her up and headed back to the chemist. This time, they said it was probably an ear infection and they couldn't help us, and that we should call the doctor in the morning. Leah was really in a lot of pain, and it was hard to get her to sleep. We had been in this situation once before last summer, and it ended in a ruptured eardrum, so I knew what was coming. In the morning, sure enough, when she woke up, her ear was full of puss, and so we knew that her eardrum had ruptured overnight. So, I called the hospital again and explained this new development. They told me to come in.

To make a long story short, we spent the best part of the day going back and forth between desks at the hospital and our house, with passports, medical records, and copies of our lease, in an attempt to register Leah with a practice. The staff at the hospital were incredibly helpful, and kept apologizing that this was difficult. In actuality, it was not that hard, but it was complicated by the fact that Leah was sick and I was trying to get her in to see someone at the same time that I was registering. (Note to future Colgate study group directors: best to register with a doctor here BEFORE one is needed). Through the whole process, I noticed that the UK system is generally just a little more flexible, and a little less legalistic, than in the U.S. I have a good bit of experience dealing with doctors, hospitals and insurance companies, and it just seems a lot less complicated here. Of course, I was just trying to deal with an ear infection this time, and I know I can't really compare it to the process of having an infant undergo major surgery at a children's hospital...(plus, that is the subject of another blog!)...but overall it did seem just easier. In the U.S, the first thing one deals with when trying to access medical care here is an insurance company, and matters of billing and co-pays. Here, none of that exists. Once we were in the NHS system, we had no problem getting in to see a doctor that day. The doctor visit was free, the antibiotic was free, the lab work that the doctor ordered for Leah was free, etc. Now that we are registered, I'm sure that none of us will actually need to visit the doctor again, but I did learn something in the process. Plus, Leah seems to be on the mend and was back at nursery today!

Slow Weekend, and Dinner with Students

Well, we had a very slow weekend around here. We intended to drive to Dundee to partake of their fabulous new leisure center, complete with indoor pool, lazy river and water slides, but it didn't work out. David took the kids to the park in the morning but when Leah came home, asleep in the "pushchair" she looked pretty sick. I could tell her fever was back. So, I spent the afternoon lying next to her in bed as she slept. It did give me a chance to finish the doll blanket I was crocheting, and while she slept I started watching the new Michael Pollan documentary on Netflix called Cooked. If you haven't seen it, I highly recommend it. The first episode, called Fire, isn't great...it's ostentatious and repetitive. However, episode 2, called "water" is worth your time for sure.

John was also feeling a little low on energy too on Saturday. I don't think he was sick as much as worn out from the week. On Thursdays, he has 90 minutes of football training after school followed by 90 minutes of rugby training that evening, and I think it is too much. Plus, he came home from tihs week's training saying that he was "gutted" that he didn't get a chance to touch the ball at training, and they are still in try-out mode so he was hoping to impress his coach. On the other hand, he was "chuffed" that he was chosen to represent Priory House (think Gryffindor, Hufflepuff, etc...) for football in the house competition.

On Sunday, only Emma and David made it to church, though I did go with Emma in the afternoon to the West Sands beach in town for a walk. It was a lovely, sunny day and the beach was so crowded that I had a hard time finding a spot at the car park. There were so many families spread out on the wide sandy beach that I felt like I was at the Jersey shore, except the temperature was much colder and everyone was wearing a lot more clothing! After the beach, we stopped at the store to buy groceries for dinner, as our students were coming over to discuss our upcoming trip to England. I decided to make a few lasagnas for dinner, but since my usual recipe doesn't translate to grams and liters too well, I went with a recipe I found online. It was a bit bizarre...it called for a bechamel sauce but no ricotta cheese, which I managed. It also called for cheddar cheese on top, and I couldn't imagine that working out well, so I went ahead and used mozzarella for that. I made one lasagna with "mince" and one with veg, and they both turned out ok, though way too browned on top from our inoperable oven. We had a bit of a time gathering enough plates and forks for everyone in this relatively ill-equipped kitchen, but the students didn't mind using a combination of mismatched, plastic, and IKEA kids' stuff. Leah rallied enough in the evening to bop around among the students, but by 7:30 she came up to me and said, "I'm ready for bed!"

A Guest Blogger!

Leah has been sick for the last two days, with a fever of 38.3...whatever that means! She alternates between lying listless on her Peppa Pig airbed, asking weakly to watch "the bees" which is a British cartoon, and lying in her play tent, dressing her baby doll despite being in a prone position. Since I have been hanging out with her, and not doing much else, Emma is going to take a turn at the blog. Take it away, Emma!

________________________

Being an American in a Scottish school means being asked loads of questions about life in "the States". I've learned that most Scots think that New York is just a city and cannot believe that I'm from a town smaller than St. Andrews, five hours from the city. One boy, upon being told that I live outside the city, said "Oh so like Brooklyn." People here also don't seem to understand just how big the county actually is, and they love to ask where I've been. In my first week, they asked, "Have you been to Compton?" I said no, then they said, "How about Detroit?"

They also all assume that it's always bright and sunny and are shocked to learn that we get snow and have much colder temperatures than they do. Some of my friends will have the opportunity to go to Ohio next year on an exchange for a week and they all seem to think that they're going to be visiting Los Angles.

I'm also constantly ambushed by classmates with preconceived notions about the U.S. from various movies and T.V. shows. They ask things like "Are there just tons of McDonalds everywhere?", "It is normal to see someone carrying a gun?", "Are your chicken nuggets way bigger than ours?", "What's wrong with your bacon?", and my personal favorite "If you walk on someone else's property will they shoot you?"

They also seem very interested in how we perceive them and were disappointed to learn that Americans generally consider British and English to be the same thing. When I told them that everyone thinks that the UK is just like Harry Potter minus the magic they were very taken aback. I was quite disappointed to learn that no one here really likes, or even has read, the Harry Potter books.

Some parts of going to school here really are just like Harry Potter, though. For instance we have this big quad in the middle of our school that looks exactly like the place where Mad-Eye Moody turned Draco Malfoy into a weasel. 

The quad at Madras College

We also have houses, although we only have three instead of the Hogwarts four. These consist of Blackfriars (for the church that used to stand where the school is now), Castle (for the St. Andrews' castle), and Priory (this is my house and I have no idea what it's for). At Madras, they really aren't a very big thing and no one really seems to care what house they're in, though we do have house games where you can earn house points!

Greener Scotland

A few weeks ago, I mentioned that I think Scotland has it over us in the way they lay out their roads, and their use of the roundabout. Here's another way in which they are ahead: they are much better at the whole reduce, reuse, recycle movement than we are. I'm speaking in general terms here, of course, and I'm sure one can find outliers in each county. As a rule, though, it is just much, much easier here to be green.

The process of dealing with one's trash (always called rubbish here) basically requires one to recycle almost everything. The council of Fife issues four different rubbish bins to each home or flat: a green one for plastic and tin (aluminum too, though they don't use that word here too much, which is a shame because it's always fun to hear them pronounce it!), a grey one for paper and cardboard, a brown one for food and garden waste, and finally a wee blue one for the remainder. This blue one is the smallest of course, and with the recycling "scheme" they have put forth, one really shouldn't have too much left to put in this last one. Also, though rubbish day comes once a week, they alternate what they pick up when, and they only collect the blue one every other week. That means that one really does have to be stingy with what one discards in this bin, because after it's discarded it's going to stick around for a while. The council places stickers on top of each bin to explain what can and can't be discarded, and the council also issues fines if an item is placed in the wrong bin. All in all, it's a system that is clearly working well. In 2010, the Scottish government set forth a "Zero Waste Plan" and tasked council with recycling or composting 50% of household waste by 2013. I think they missed that mark by just a bit, but at this point the recycling rate is about 43%, certainly much higher than the rate of recycling in the United States.

The bins outside our house. Notice the blue one, for general rubbish, is about half the size of the others. Thank you for NOT noticing the disgusting mold in the corner, by the way...

A sticker one top of one the bins directing the user, in a typically polite British way, what to put in the bin and what not to put in the bin. Yes, please, to tabloid magazines, but no thanks to sweet and crisp wrappers (which, by the way, is referring to certain foods here. Despite the implication here, wrappers do not come in varying flavors or textures, so not to worry...).

Not only are they recycling more of what they bring home, but they aren't bringing home as much to throw away as we are in the first place. When you purchase something from a store here, they never give you a bag to put it in. They do ask if you need a bag, and if you do they will gladly sell you one. Most stores have durable, reusable shopping bags "on offer" like they do in the U.S., and most folks have a decent collection of those in the boot of their cars and their homes, etc. But they also sell thin plastic shopping bags, meant for only a few shopping trips, for about 5 pence each. It's rare to see anyone buy one, because most people here are also equipped with a foldaway shopper bag in their pocket or purse or wherever. I saw a number of people with these in the first few weeks we were here, and so I bought the one below for myself and one for Emma. It comes with a wee case and so when it's not in use, one can stuff it back into the case so that it takes up almost no room. This thing is rarely in the case, though, and I find that I am using it all the time, at the grocery store, the drug store, the vegetable store, etc. Yesterday I popped into town to return some library books (carrying them in this bag), and on the way home I stopped for a bit of cheese at the cheese shop in town. The woman at the shop took my money, gave me my change and the wax-paper wrapped bit of cheese, and in it went in the bottom of the bag. A few stores down, I stopped at the bakery for a baguette, and after that transaction the baguette went into the bag as well. At the end of the street, I stopped into a little produce shop that sells a different soup kit each week. This is a printed recipe for a vegetarian soup and all the vegetables that one would need to make it. This week's soup was sweet chili and swede, and so along with the printed recipe, an onion, a red pepper, a chili pepper, a half of a swede and a few cloves of garlic, plus a vegetable stock cube, went into the bag. By the time I got home, I had the fixings for dinner, and aside from the wax paper that covered the cheese, I didn't have a single bit of rubbish to throw away. Imagine how much rubbish I would have after a quick trip to the supermarket in the United States to gather items for a family dinner!

Leah's language

It's a little too soon for Leah to pick up a Scottish accent, but I do notice that some of her intonation is changing a bit after spending time in nursery (I still call it school, and pronounce "skew-el" like a true Midwesterner, but I'm the only one. ) Leah's teachers say "nar-sarrry" with a rolling r sound that I still can't make, and they don't use any article in front of the word...similar to the way the British refer to a trip to the hospital: "he was taken to hospital."

Yesterday, when I picked Leah up the teachers informed me that she had lasagna for lunch, but they said it in such a way that I had a hard time picking up the actual word. On the way home, I tried to get Leah to repeat the word in the hopes that she would use the same pronunciation, but at first she forgot completely what had been served, then when she remembered, she said, "Oh, lunch was za-zan-ya!" I'm sure that's not what they said, so I moved on.

I do see her put a bit of a British inflection at the end of a question, so the question kind of curves around at the end in a different way than it does in an American accent, if that makes sense. She's also starting to pronounce some words in a slightly different way as a result of being around her teachers and the other kids. Her "no" is much longer and more drawn out now, and includes almost every vowel available, like "naiou." Her yes is the same, but I'm assuming that might change since most of the kids actually use the word "aye" as an affirmative instead. There's a little girl in her class named Orlaith that is very kind to Leah, and I always make a point of going up to her at drop-off to ask her simple questions just so I can hear her say, "Oh, aye! aye!" in her wee Scottish accent.

Since her nursery is on a farm, a lot of the stories she tells about being there revolve around what she called "aminals." She talks about the sheep a lot, of course, and sometimes the cows. There are horses there too but they are kept very far away from the children so she doesn't see them as much. One of the barns not used in the nursery is full of cooing doves and sometimes owls, and Leah is able to distinguish between the sounds they make from lots of practice. The other day she was going through the kinds of sounds that the different animals make, and she said, "well, a cow says moo and a dog says meow." I said, "A dog says meow?" She added, "and then the cat says, 'what's he on about?" in a very British accent. I think this must be a quote from a teacher, or a line in a book that they read at school, but in any case it really made me laugh.

The nursery does have a proper garden with play equipment, but one advantage of going to nursery on a farm is that there's all kind of interesting equipment to see on the walks.

Leah's the one in the bright pink snowsuit, by the way. Note that I did buy her the requisite hat with ear flaps that all the other kids have here!

Castle Campbell

We took a drive to Clackmanannshire on Sunday afternoon. It was nice and sunny on the coast but as we drove inland the clouds started to roll in and by the time we squeezed our way into a car park perched precariously on the edge of a hill in the little village of Dollar, it was quite drizzly. We were prepared with rain gear, and pressed on. It was quite a hike to the castle itself, and Leah insisted on walking it by herself. We sent David and Emma up ahead so they didn't have to wait for us, and so that we could have some extra time for Leah and John to splash in all the puddles and streams on the way.

Castle Campbell is a large tower castle that was built on a large ridge in the 15th century. It was originally called Castle Glume (clearly named on a day like today), but when the Campbell clan took over, they tried to brighten up the place a bit by adding some garden terraces. It's hemmed in by two deep ravines, one called the Burn of Sorrow and the other called the Burn of Care. The castle itself is impressive in that all four floors are in great shape and are accessible by an impressive circular staircase. The setting, though, is the real attraction. We tried not to oversell the castle to Leah, since her idea of a proper castle is still in line with what she sees in books and we know this one may not measure up. She was impressed nonetheless, though, and when we spotted David and Emma inside the caste walls, she ran up to them shouting, "Daddy! We found the largest castle in the world!"

After a quick tour of the tower and the surrounding range, we headed down a muddy path that led to the ravine. The rain had created some impressive waterfalls and the ravine is full of mossy rocks and ferns. John had brought his muck boots along on this trip, and so he really got to explore every nook and cranny. It was a bit too "slippy" for Leah, so David followed behind with her, alternating between holding her hand, and carrying her by the scruff of her snowsuit like she was a baby bunny when the ravine got too deep. It was a lovely hike, and in parts resembled New Zealand more than Scotland. It was a bit damp, but we had dry clothes and hot tea waiting for us in the car at the end!

Leven and Pittenweem

On Friday night, Emma met her friend in town for a movie, and I took Leah to the leisure center in St. Andrews for an hour in the toddler pool. This was our first foray to the center, and I wasn't sure what to expect, but it turned out to be a lovely place...just what we need. There's a big lane pool with a zero-depth entry, perfect for toddlers, plus a large toddler pool. That pool is actually nice and deep and the water comes up to the top of Leah's shoulders when she is standing on the floor, so it's unlike those ankle-deep things that used to be a part of every community pool in the United States, which one knew were half full of chlorine and half of urine. This pool also had a little dolphin-shaped toddler slide which Leah enjoyed very much. The water was quite warm, luckily for me, and we both had a great time during our hour-long session.

On Saturday, we packed up all of our warmest clothes and drove to the village of Leven, which is about an hour away from St. Andrews along the Fife coast. We were in search of a little plastic drain clearer to fix the drain in the kids' shower, and David had read online that there was a store that sold them there. There's also a nice beach there, though, and a long promenade along the sea wall, so we packed a few snacks and some tea and headed off. When we arrived, we found the shop in a pedestrian-only high street, and though it turned out that the shop didn't have the little plastic drain clearer after all we did find a few other things of interest. We then headed towards the beach, after putting on every pair of windproof pants and shoes and gloves and scarves and hats that we brought. Leah found a friend on the playground and Emma and John started up a game of soccer on the grass nearby.

When we were too cold to bend our appendages any longer, we got back in the car and headed back towards St. Andrews but drove along the coast instead of taking the inland road. After a bit, we arrived in the fishing village of Pittenweem. Leah and John fell asleep on the drive, so David parked the car at the harbour facing all the fishing boats as they came back in from their morning fishing trips, and settled in with a book he had brought from home (he's wise to the fact that this situation arises quite a lot!)

While everyone else slept and read, Emma and I took a walk through the village. We were in search of St. Filian's cave, about which I had read in a guidebook at the house. I'm not a huge fan of caves, so I didn't intend to go in, though one can gain entry by picking up a key at one of the nearby cafes.

We also came upon a wee black cat on our walk (see photo above). After a short walk, we found a yarn shop that looked interesting. Since Emma is trying to teach herself to knit, we went in. There were two women inside, one a Scot and one an American who now lived in Pittenweem, and they both helped us figure out what kind of yarn would work best for Emma's project. I don't know much at all about yarn, but I could tell that there were some beautiful options here, so anyone who did know anything about yarn would have been quite impressed with this place.

Emma chose some blue-grey Shetland wool yarn called "Highland Mist" and I left with a wee "learn to crochet" kit. I actually do know how to crochet but I haven't done any crochet in about 30 years so I think a refresher is in order. The kit included enough yarn to make a facecloth, and that is sized just right for Leah's dolls, so in the end it worked out for three of us.

Next, Emma and I picked up John at the car, and the three of us wandered into the Cocoa Tree Cafe for a snack. I felt bad leaving David in the car, but chocolate isn't his favorite so he was happy to give this one a miss. The cafe was surprisingly crowded for such a sleepy little village, though I did notice that a number of our fellow cafe-goers had backpacking equipment with them, so I presume that many of them were taking a short break from a long coastal hike. The three of us were seated on a couch in the corner, and John ordered a piece of chocolate cake while Emma had a scone with raspberry jam. The chocolate cake was delicious but quite sophisticated (I think the sponge cake was soaked in a chocolate liqueur) so he didn't care for it. Emma's scone was delicious, and the raspberry jam was clearly homemade. I ordered a wee mug of dark hot chocolate which was lovely and thick, but seriously bitter. I also generously helped John out with his chocolate cake!