'An English doctor would probably have tried to woo me a little before getting my trousers off'

I don't know whether it's because I'm experiencing it through the filter of a different language, or if it really is a cultural thing, but medical care in Sweden is always a delight.

Back in the UK it always seemed that medical visits - doctor, dentist, optician or whatever - were steeped in that layer of Britishness where everyone is so polite and doesn't want to offend anyone and you follow the unwritten rules of contact. Here in Sweden it seems there are no rules. Or if there are, no one has told me what they are yet.

Yesterday was a case in point. I had to visit the doctor as I had been getting odd pains in my leg. Now, I know, know, know that I should try and speak Swedish, and I truly believe that when you live in a country you should do your best to assimilate and speak the language of that country, but when I'm sitting there across from the doctor, and I just don't have all the particular words for the particular types of ache, pain, throb, wobble or pop, and I know the doctor has excellent English skills, I just give in and ask if it is okay that we speak English.

In my defence though, Swedish society is conditioning me to request English. When I phone almost any government agency or large Swedish company, the automated switchboard voice always says "For English, press 5", and so I do. And not just because the waiting time seems much shorter in the English queue. Although, that helps, obviously.

So I was sitting opposite the doctor, and had just gone through my symptoms (I won't bore you) and a silence had fallen. He sat back in his chair and said:

"What do you think the problem is?" stressing the "you".

I paused slightly, and then thought I might as well go ahead and admit that I had spent several hours the previous night Googling my symptoms.

"You doctors must hate the Internet" I said and he smiled, "because I did have a look at a few websites last night, and I was thinking, maybe a hamstring injury, maybe sciatica."

"Could be, could be." he nodded.

"But then I’m not a doctor."

"No, no you're not. Take off your trousers."

And here's where the English/Swedish differences show up. An English doctor would probably have tried to woo me a little before getting my trousers off. Something like: "Hmm. Well, I think we'd probably better take a little look. If you'd be good enough to take off your trousers, you can put them on that chair there, and lay on the table there I'll examine you". Wooing. Still, there's something to be said for getting right down to it.

As I removed my trousers some small change fell out of the pockets and rolled across the floor.

"Looks like I'm giving you a tip already and you haven't done anything yet!" I said, making a silly joke, as I often do to break the tension whenever I'm taking off my trousers in front of a complete stranger. He gave a HUGE guffaw and laughed longer than I thought my rather weak joke merited.

This is something I have noticed before with Swedish medical people. If you bring humour into the conversation they react totally out of proportion. The other month I was with my little boy at the dentist, and she wanted to take some photos of his front teeth just so she could send them to a colleague for his advice, so she took out her smartphone and took a few snaps. I joked to my son: "I think she's going to put those on Instagram." and the dentist and her assistant laughed as if I'd told the funniest joke in the world ever (you know, the one about the goat and the vacuum cleaner). Do Swedish people not try and inject a little levity into medical meetings? Are medical professionals so starved of humour that the weakest of jokes causes major merriment? It always perplexes me.

Anyway, when he stopped laughing and I reclaimed my coinage, he gestured to the examination table.

"You can lay down there."

I lay down and he started to examine my leg.

"Does this hurt?" he said, trying to hurt me.

"No."

"How about this?"

"Well, it's not pleasant. But I wouldn't say it hurts. As I said, I have a bit of dull ache all the time anyway."

He jabbed at the side of my knee with his finger and said:

"That has to hurt."

"A little."

"Good." He said, slightly relieved that his medical skills were still sharp and pointy. Then he looked at my other leg. As his hands were on my thigh he looked up at me and smiled a little.

"You work out don’t you?" he said.

"Well…" I didn't want to let him down, and I was mildly flattered, so I nodded. "Sort of."

"Do you play football too?" he asked. I don't, just a kickabout with the children, but I found myself nodding again.

"Hmm." he muttered, returning to my leg.

Anyway, he continued examining me, and then decided that he needed to look at my feet more closely, so he took my socks off. You know, I don't think that, as an adult, anyone has ever taken off my socks for me. I rather liked it. He was rubbing and feeling and poking my feet when he suddenly stopped short. I knew exactly what it was that had shocked him into stillness.

Now, I should tell you something about my feet. About, oh I don't know, maybe 15 or so years ago I noticed that I had two identical little bumps on the tops of each foot. Quite noticeable, like two little mounds of rigid jelly balancing precariously on my feet, slightly pale, sort of disgusting. I don't really know how they got there. Whether they grew, or they just appeared overnight or what happened. I hadn't got into the habit of checking my feet every day (or week or month or whatever) so I really don't know how long they took to arrive, or when exactly they arrived. I just became aware of them one day and thought "Well, that's a surprise." There was never any pain, and they never grew, so I never bothered about them. However, my wife noticed them and she suggested, some years previously, when I was seeing another doctor about something else, that I should ask about my feet. After examining me, that doctor (also a Swedish doctor) said:

"I have never seen anything like that before."

“Ah-ha. So, should I be worried?”

"Well, you say you have no pain, and they aren't growing…and you have one on each foot. And they're quite symmetrical. That's a good sign."

"Is it?"

"I suppose it must be."

"So…what do you think they might be?"

"I have no idea. Best just to leave them alone."

And that is why Swedish medical professionals are a delight. If they don't know what something is, they won't try and pretend that they might have an idea what it is, they just put their hands up and say "no, you got me there" and say that if you have two of something in the same place, then you're probably meant to have them, for some strange reason. Part of the universal plan as yet unrevealed to us. They won't send you for months of random tests, they'll just tell you come back if things start to hurt, grow, explode or, God forbid, leak.

So, anyway, this new doctor had noticed these two odd blobs on my feet and had gone quiet.

"Ah," I said, "you've noticed those two things on my feet. I did ask a doctor some years ago about them, but he said they were symmetrical and I shouldn't be worried."

"They are very symmetrical. How long have you had them?" So I told him a little of the story, and then asked if he knew what they were.

"They could be ganglion. But I've never seen ganglion like that before. But you have no pain, and they haven't grown?"

"Not at all."

"Then just leave them alone."

Which I was quite happy to do. After I put my trousers and socks back on and we were sitting facing each other again it went very quiet once more.

"So what do you think the problem might be?" I asked him, stressing the "you".

"Might be osteoarthritis. Might be nothing. Have you been on a long-haul flight recently?"

"Well, we flew to Japan, but that was back in March."

"Could be deep vein thrombosis then."

"Really? Even four months after the flight?"

"Anything is possible. We should do a blood test before you go."

"Okay, but if it isn't that…"

"There are physiotherapists around. You could go and see one of them."

"For osteoarthritis?"

"You're young, but you're old. If you understand me."

And just like that he erased the flattered ego brought about by the "you work out" comment. I guess he really meant something like "You know, for your age, you haven't really fallen apart yet."

"But it might be sciatica? Or a hamstring injury?"

"Anything's possible. But I think a physiotherapist. There are lots around."

So, as I said, a delight. British medical professionals want to make you think that they know everything and love to give their opinion, or refer you to a clinic for further tests. In Sweden they love a mystery. I always feel much healthier whenever I leave a Swedish doctor. And a little bit special.

David Ashby, from Brighton, moved to Gothenburg in 2002. He is a certified English as a Foreign Language teacher who today teaches business English in Stockholm. Read more about him here.