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  1. Normunds Suna
  1. Correspondence to Dr Normunds Suna, Neurology Department, Riga East Clinical University Hospital “Gailezers”, 2 Hipokrata Street, LV-1038, Riga, Latvia; n.suuna{at}

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Latvia was recently nominated Europe’s best-kept secret by some international media (figures 1 and 2). I would like to disclose some secrets of the Latvian medical system, not known to the rest of the world, with a special emphasis on neurology. To understand our medical system properly, it is useful to have some historical background. Latvia was independent before World War II, with its own non-Slavonic language. Our country chose to stay neutral during the War but this did not prevent it from being occupied and forcibly incorporated into the Soviet Union; the intellectual elite were deported to concentration camps in Siberia and this continued long after the War ended. The 50-year oppression of the Soviet regime has left a permanent scar on our culture, in both daily life and medicine. I was 9 years of age when Latvia regained its independence in 1991 (figure 3).

Figure 1

Flag of Latvia.

Figure 2

Location of Latvia in Europe.

Figure 3

Freedom monument.

I started neurology training 15 years later. I remember meeting some very special inpatients whose problems seem mainly psychogenic from today's perspective. For example, a middle-aged woman with a garish hair bun, pink plush bathrobe and pink slippers carrying a cotton towel in her hand, slowly walking through the corridor towards one of the most advanced therapeutic procedure, a hyperbaric oxygenation session, something believed to improve the course of the vast majority of neurological diseases as well as health in general. Elderly colleagues explained that in Soviet times people came into hospital a couple of times a year to improve health. Indeed, it was common for my patients concerned about their health to ask their family doctor for a referral to hospital in order to undergo various health-improving physical procedures …

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  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed. This article was reviewed by Tom Hughes, Cardiff, UK.

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