---
title: My First Scalpel
abstract: "Geen kleintje!"
categories:
- personal
content-tags:
- health
- amsterdam
---

Today I had my first surgical experience. It was not very dramatic.

I have a fairly common genetic condition that causes lipoma to form in my fat tissue. These are basically benign tumors and usually are not noticeable. But a pair below my right knee, despite hiding well with the joint, had grown to the point of causing discomfort. I also had one small one on the thigh that wasn't visible at all but would press against muscle tissue and cause some ache after exercising.

So when I switched GPs this year, I brought them up and was given a referral to the hospital to have them removed. It's been a fascinating experience to see how the Dutch healthcare system works. I've since taken a short tram ride (or even walked) to the "east" hospital for an initial consultation, for an MRI scan, to discuss the scan results, and now for the actual surgery. Each time, I walk into the mid-century building that feels more like an airport than an American hospital and follow the signs to the appropriate desk, show them my ID, and wait up to 10 minutes. Then I am greeted by friendly professionals who don't flinch when I say "Engels, alsjeblieft" and switch to speaking English while escorting me to a simple room with minimal fuss.

The surgery itself was surprisingly understated. I walked directly into an operating room and sat on the table in my street clothes, while a surgeon, surgery resident, internist, and nurse (all women) went to work. No need to recount the details, but it's interesting that the anesthetic was very localized, and it all felt very informal even though the surgeons were clearly skilled. The large tumor was even bigger than expected ("Geen kleintje!" the nurse declared) and they let me choose how much I saw as we went. It all took less than an hour from showing my ID to walking (stiffly) out.

I cannot say from experience, but based on my research I expect my experience in the US would have been quite different. I still wouldn't have spent the night, but probably would have spent significant time in prep and recovery and been wheeled around on a stretcher.

Costs are much lower here. This may be partly because the process was spartan, partly because the doctors don't have student loans, and largely because the whole system is regulated as "managed chaos" so that it doesn't suffer from the cost disease plaguing the US market. So even though I have almost no costs, the insured costs are so low that I'll remain on the paying-in side of the social equation.

One more observation about how Dutch this experience has been. They gave me no painkillers, so now that the anesthetic has completely worn off and the incisions are beginning to hurt, I have only paracetamol. Because comfort would not be worth the risk.
