Monday, June 29, 2009

My Experience in a German Hospital, Part III

13 comments
Back to the clinic for me. This time it was in full swing, rather than abandoned. I was examined pretty quickly after arriving, then had to wait in the hall on a cot waiting for some test results. While I was lying there, both of the doctors who I'd seen in my first hospital visit came by. They must just live there. They recognized me and were interested in what was happening. After the test results came back, the Oberarzt who did my operation consulted with the head of the department about my case and they decided to admit me to the hospital again for medication and observation.

I wasn't there for more surgery, but there was again no space on the wards for me, so I was admitted to a bed in the same post-op area I'd been in before. It was nice to already know the nurses, but I had a distinct feeling of not belonging there! The Oberarzt came by and sat down to tell us everything that was going on in detail. They wanted me to stay overnight for observation and have some medication.

That night I stayed in post-op due to the continued lack of space on the wards. Not much was going on with me but I appreciated their abundance of caution nonetheless. I actually suspect there was some friction between two of the doctors - the surgeon who operated and the doctor who was rounding - about whether I should remain in the hospital and how long.

The next day, I was moved to the wards. The room was really big and shared with two other patients. It was in an older building, but you couldn't tell at all from the inside. There was a table and chairs, which I really appreciated, because by then I was feeling too well to be sitting in the bed all the time. I also spent a lot of time in the hallway looking out the windows. Being in the hospital is very strange indeed. Life had come to a halt for me. I did Sudoku puzzles and wrote Christmas postcards and napped all day while everyone outside went to work, shopped for Christmas gifts, and drank Gluehwein in the Uni-Platz. I felt bad about feeling this way, though. I was clearly one of the healthiest people on the ward and had no room to complain.

My roommates were two older women, both as local as could be, with accents to match. One of them was nearly impossible to understand. I had to refer to them by last names, of course - very formal, despite getting to see their bums and pee-filled catheter bags and whatever else - it was interesting to cling onto that piece of dignity. Speaking of names, I was amazed that I never had an identifying wrist band during this entire experience. There was a label hanging on the end of my bed to identify me!! I think a system like this could actually cause a US hospital to lose accreditation.

Anyway, the women were both really nice and put up with my horrible German very gracefully. At one point one of the nurses had left our bathroom light on and as I was up walking around, one of the ladies asked me to turn off the bathroom light. These are very simple words that I know, but I could not for the life of me figure out what she was saying. She just kept at it over and over and I still had no clue. Finally the other woman, with her slightly clearer accent, told me that she wanted the bathroom light off. Then they proceeded to explain that one should not leave the lights on because electricity is very expensive. That was such a cute German moment, that they cared about the hospital's electricity bill, and they were going to make sure that I was informed on that matter. The woman with the clearer accent was a hoot, too. She loved to gab and gab, and her favorite word was gell, a sort of regional word that's somewhat like tacking "...right?" on the end of sentences. In her case, on every single sentence. When she talked I started to dream up goofy images of us all drowning in a sea of gells, being buried under an ever-growing pile of gells, gells oozing out from under our hospital room door, dodging swarms of gell bullets...you get the idea.

I was on the wards for two uneventful nights, being observed. I needed so little from the nurses, but this was a good thing, because one of my roommates needed direct attention from multiple nurses about half the hours of the day, it seemed. She had IV port troubles, bed sores, couldn't get up alone, etc. I had the sense that the hospital was very understaffed, nursing-wise - there were plenty of doctors. A couple of times when I did need something, I had to remind them again to finally get it...and that's only if I knew I needed it. At one point I was chided for not wearing anti-blood-clot socks, which I never knew I needed. Apparently this was a major breach of protocol, even though I spent most of the day wandering the halls and probably didn't have a very high risk of thrombosis. But, how would I know? It was an overworked nurse who dropped the ball there. They told me at one point my blood should be checked, but no one came to draw it. One of the other patients explained to me that competition in Heidelberg for nurses is pretty stiff because there are so many places for them to work. Overworked nurses are a big problem in the US too, where there simply aren't enough of them in the pipeline.

One of the nurses was obsessed with American presidents and really wanted to discuss them with me at every possible opportunity - in German, of course. (Not as many people on the wards were willing to speak English as in post-op.) I now thank my high school history teacher, Mr. Peterson, for forcing us to memorize all the American presidents in order, because this guy "tested" me on the presidents by asking me to name them by telling me their number in the sequence. Yay for managing not to perpetuate any stereotypes about Americans being stupid!

I think I was in the hospital too long unnecessarily, but again, when contrasted with the US problem of being kicked out of the hospital too soon, I'd rather be stuck there too long. It just amounts to less worry for me, despite knowing all too well that hospitals are probably not the least dangerous place a person could be.

In the mail I received the doctor's letters about the surgery and the second hospital stay. I received two hospital bills. Not multiple claim letters, not denied claims that had to be sorted, not long scary itemized lists. Just two pieces of paper, one for each stay. The surgery, the bed, the care, the medications, the meals, all just 10 EUR per night plus a 10 EUR fee per stay, for a total of 70 EUR. I paid it and that was the end of that. For follow up appointments, the usual protocol for doctor's visits was followed: you must pay a 10 EUR copay for your first doctor's visit each quarter - so four times a year at maximum. There's no copay for any further visits in that quarter. I was impressed! Damon and I were, at the time, covered under voluntary state insurance which matched what I got when I was employed earlier (I was not employed in December). For both of us it cost around 150 EUR per month. (When you are employed, you pay a portion of your insurance cost and your employer pays the rest.) After my experience in the US with health insurance - I had what's considered very good coverage there, but had to pay more for everything and they constantly made 'mistakes' on claims that I had to call in to argue with them about - I think the system is much easier to navigate here, and far less stressful. And everyone knows - stress is not good for your health. ;) Here's an interesting article on the positives and negatives of the German system.

Still, not everyone has experiences as positive as mine. I think there may especially be difficulties in the states of the former East. Here's a less favorable hospital story from Dresden (scroll past the first entry).

I know others who read here have also posted hospital stories. If you could give me the links, I will add them here. :) Stories from all countries welcome!

13 comments:

  1. Thanks for sharing your story. In March I had my tonsils out, and was amazed at the differences between the German and American health care systems. I spent 6 days in the hospital (in the US I think it would have been more like 8 hours), and spent 60 Euros (who knows how much it would have cost in the US). In general, even with the lack of pain medicine other than paracetamol, I was pretty impressed with the German system.

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  2. Wow, this has been quite the adventure to read about.

    I'm glad that your experience, overall, was good--and that you're now healthy.

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  3. I was kind of shocked when they told me I'd be in the hospital for 8 days. In the U.S. and Canada, the procedure I had done is considered "drive thru" surgery and people often go home after 24 or even on the same day sometimes, depending on what their insurance will pay for. I thought staying in a week would be torture, and it was in some ways, but I was able to recuperate better than I would have at home and I'm glad things are the way they are here.

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  4. I'm glad you're healthy now... I am wondering though, if you don't mind me asking what it was that took you from being in pain to needing emergency surgery that same day. And which hospital was this? Thanks.

    My e-mail address is earthtobellablog[at]gmail.com

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  5. her favorite word was gell, a sort of regional word that's somewhat like tacking "...right?" on the end of sentences.

    I am a late adopter of the gell. You might say it took a while to gell with me (but only I would laugh along with you if you were to do that, so don't bother). The local Oberpfälzer pronunciation seems be more like gelwü? if you were to say the first half of the 'l' but glide into an ü (the transition here is represented by the 'w' in my own personal phonetic ascii shorthand).

    this guy "tested" me on the presidents by asking me to name them by telling me their number in the sequence.

    I was never able to do that. I have a good idea of which part of which century for a given presidential name-dropping, but the whole in-order thing was out of my reach. I wonder about rote memorization of stuff like that sometimes. Do they do that in schools here? I only attended 10. Klasse in Germany, so I don't have the full picture. I wonder whether the prevailing German opinion is whether that sort of thing — along with spelling bees — is a useful expenditure of learning resources. A few have asked me about that and I think it's a question of perspective and tolerance for both Klowns and the more traditional Clowns and being able to successfully guess at so many other words.

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  6. Amanda: The pain medicine aspect is definitely very interesting. In contrast, when I had my wisdom teeth out in the US, my dentist sent me home with a prescription for Vicodin even before I knew whether I was going to have really severe pain. I filled the scrip right away just in case, and never needed it at all. Tylenol was more than enough.

    Adam: Thanks :)

    Christina: The differences in length of stay are amazing. Length of stay is actually a quality measure in the US - it's considered the lower the better - which I always found sort of disturbing. I don't know if that's really about quality so much as cost. Despite lowering it so much, health care costs in the US are still higher, so I guess it hasn't helped. :/

    Bella: Thanks :)

    Cliff: Interesting regional variant! As for rote memorization, the way you learned them is probably more useful. I can't come up with dates to save my life, but knowing dates is more significant than knowing the order. The good thing about rote memorization is that it really stays with you.

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  7. Thanks for sharing your story and for the PBS link. I had watched that program but didn't see the website companion.

    Glad you were the American being tested about Presidents! I didn't have a Mr. Peterson but I do know the state capitals (not like that helps me much here).

    I also had a hospital visit but I don't think I am ready to write about it. Your experience seems pretty similar to mine. One of the things that stuck out though was the nurse chiding me for not bringing Hausschuhe! (This was also an emergency thing)

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  8. All my microbiolgy classes taught me that the hospital was a far better place to be out of, rather than in. It's interesting: here in Germany I am often offerred the opportunity to stay in hospital in a totally ridiculous manner. I just say no and go home. But then, I also went home 11 hours after having my first child, and now think that was a trifle too short:).
    So my take on it is: when it slices muscles, stay in.Otherwise, home is better.
    Glad for the happy ending.

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  9. I have heard people say "gell?" as a tag question in these parts too, but the Erfurter variant is "ge?"

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  10. We too have the "drive thru" surgeries. It depends on how bad it is. The drive thru is called "Ambulant". Usually pancreas is something they send you home the same day, or if it is a simple knee surgery etc.

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  11. Hey all, BIG apologies on being so slow with the moderation. I thought it would email me when a comment came for moderation, as it did last time I had moderation on. Instead they were all piling up on my Blogger dashboard, which I wasn't even checking!!

    Yelli: Yes, they were surprised I didn't have more things with me! I guess they forgot it was an emergency and I wasn't exactly planning on staying over!

    G: Yes, better not to be in the hospital overall. My entire job in Boston was to know this fact, essentially. But for some reason I would still rather err on this side, then having to go home too early and hem and haw over every little thing - "is this normal? is that? should i call in? should i not?" etc.

    Arashi: So they are a bit more lazy there with their gells ;)

    Nelly: They do have their positives!

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  12. I'm glad to hear about your experience, since I'm going for surgery tomorrow. Thanks.

    I was also concerned about being required to stay so long. I asked a doctor friend about it, and he said, "Theoretically, you could go home afterwards, but you'd just have to come back each day so we could check on your nose. Why not let us pamper you?"

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  13. Such an interesting experience. I hated wearing the strumphose as well, so laughed when you got in trouble for not wearing them. I can't believe how cheap your stay was. Mine would have been over 500EU/night had my insurance not covered it, which fortunately it did. Regarding the privacy, I never thought about how it must be for the other patients having to see all that - too much information for me.

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