“OK now you take off your clothes.”

Adventures in Swedish healthcare (Plus: what's really involved in a Swedish Massage ).

We were visiting my brother-in-law in Gothenburg¹ a few summers ago when my husband surprised me with an early birthday gift: a solo visit to a fancy spa in the centre of town.

There’s a certain international-western-world sameness to the trappings of such places: the lobby of this Gothenburg spa could have easily been swapped out for any of the Ontario spa lobbies I’d visited, as could the locker facilities and the area where I waited for my appointed massage therapist to come and collect me. But that’s where the similarities ended.

While the behaviour and general aspect of the reception-desk staff was essentially identical to what I’d experienced in my equally wealthy and culturally reticent homeland, the giant massage therapist who strode into the waiting area was something else altogether. As well as being enormous, he had the gait and appearance that I associate with stereotypes of dockworkers; he lumbered, yet in a way that was somehow nimble; his tattoos looked old and not particularly premeditated; he seemed like he would be comfortable tossing lumber out of a cargo hold while yelling jocular obscenities over his shoulder. He was gruff and amiable. He smelled of cigarettes.

When one enters any RMT² massage-table room in Ontario, the procedure is identical (I assume it is standardized and determined by the relevant licensing body): the RMT goes over the health history form you’ve just filled out; asks you questions about the nature of your muscle pain; hands you a consent form to sign for working on “sensitive areas,” if applicable; then leaves the room for 2-5 minutes, after instructing you to “undress to your level of comfort” and lie face-down under the massage table sheet.

Herr Dockworker av Göteborg, on the other hand, asked me a few cursory questions (there was no health history form³), held up a white sheet, averted his eyes, and said something along the lines of ‘well, go on then’. It took me probably a good ten seconds to realize that I was now supposed to take off my clothes and lie down.

Since I am fortunate to have a pleasantly pragmatic relationship to my body, and Herr Dockworker gave me zero creepo vibes⁴, my main reaction to this was ‘great, more massage time!’ But soon (after i left the spa, that is) I started thinking about how uncomfortable it would have made many North Americans to be expected to undress like that in front of a stranger.

I never really noticed how prudish we are as a culture until I started dating a European. On one of his early visits to Canada, my future husband and I went to a large amusement park about 50 kilometres outside of Toronto⁵; in the water-park area we diverted into gender-separated change rooms and when we met up again on the other side he had a look of amused incredulity on his face.

“There are change rooms inside the change rooms,” he said.

I looked at him blankly, so he went on.

“There’s a whole big change room with lots of space, but there are also all these additional little changing rooms *inside* that room.”

“Oh right,” (I was catching on). “I guess some people want more privacy?”

He shrugged, looking bemused. “I guess.”

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Once I’d moved to Europe, I was particularly grateful for my Swedish Massage experience; it meant I understood, much more quickly than I otherwise would have, what was expected of me when a Swedish gynecologist sat down in front of the hospital⁶ examining chair and just sort of waved her hand at it.

In Canada—or, at least, in Ontario, which was the only place I’d had a gynecological exam before moving to Sweden—not only does the doctor or technician leave the room while you take off your pants, she also instructs you, before she leaves, to cover yourself up with a big sheet of crinkly white medical paper⁷. That way, when she comes back in the room and sticks the medical wand or her gloved hand up inside you, she does so through the opening in a flimsy little paper tunnel.

Perhaps needless to say at this point in my story, there is no such paper tunnel in Swedish gynecological rooms. And after a few minutes of sitting there in the familiar examining position but without the familiar covering, the whole crinkly flimsy paper blanket thing suddenly seemed very silly. Really, what’s the point of getting all demure about the thighs when someone is peering right up your vagina?

But although I have decided that I am solidly in favour of the no-nonsense Swedish approach to professionally caring for bodies, I still find myself surprised by it every time. No doubt this will fade as I pass more years here in Sweden; but for the time being I’m noticing just how ingrained Ontario health care rituals are in me. I don’t think I had ever in my life given a thought to the standard leave-the-room-while-you-scramble-to-cover-whatever-bits-you-can procedure, let alone thought about it as a ritual—but a ritual it is, and one which I have discovered I’m glad to be rid of.

Last month I went to get my first Swedish pap smear. Of course I should have known what to expect (the gynecological exam I described above had happened months earlier) but still—when the kind, unhurried, and warm-yet-tactful technician swivelled her stool from the computer to the examining chair and said, while looking mildly out the window at the snow,

“OK now you take off your clothes,”

I paused, not so much startled as momentarily disoriented, needing a second to re-calibrate, to remember that, from now on, some rituals will never be the same.

1. Called Göteborg in Swedish.

2. Registered Massage Therapist.

3. Which honestly for me was so nice. I get why it’s probably a good idea, but also…. do y’all really need to know that I’ve had a bunch of UTIs and take little orange pills every day to stay functionally sane in order to rub my muscles for 45 minutes?

4. Ladies, you know what I mean. Some dudes give you the creep vibes and some don’t; it’s a shitty—but very necessary, and in that sense welcome—sixth sense we all develop after a few years of being a woman in the world: that spidey sense that you’ve got to have your guard up, or not. Of course we can always be (un)pleasantly surprised, but, personally, when I feel that blessed lack-of-creep vibe, I trust it—if only because it’s just too exhausting to be on alert all the time.

5. It’s called (very stupidly, I suddenly realize) Canada’s Wonderland.

6. I’d gone into the ER (last fall) with unidentified lower abdominal pain which ended up being, as far as anyone could tell, nothing. But they checked me out very thoroughly to make as sure as they could. It was some of the best—calmest, most communicative and respectful, and most thorough—medical care I’ve ever had.

7. You know, that stuff which lays in a strip on every doctor’s examining bed and dentist’s chair and most closely resembles tissue paper.