Either a year ago or a month or so ago or both, my heart rate accelerated in a near useless Arrhythmia (irregular) and speedy pulse, I have vague memories of a doc recently describing one of the chambers of my heart being a place where blood didn’t pump through so much as swish around.
Now that’s an image.
Because I was also parsing what at first appeared to be an upper respiratory virus and then a bronchitis invasion, the heart irregularity didn’t come forward till after the antibiotics ran out. I was still breathless. And one thing led to another so that by Tuesday, the 6th of December, I was checking myself into the local German Heart hospital. I’m here to share some of that experience because spending time in a hospital is a part of learning how things are different here.
Number Centered Check In – The Germans are take-a -number line happy. Most any official transaction, starts by taking a numbered piece of paper from a machine. You wait, watching the number board, until your number appears. Then you go find the office or cubical indicated on the number board. Its actually not a bad way to handle processing of appointment in order of arrival. Its just a little odd to go through the process when the doctor back at the medical office has just said, “get thee to a hospital.” Okay, great. I may or may not be having a heart attack but in the meantime I can wait here in the main lobby with my little number slip in my hand. It moved along quickly enough and I got my little arm band and I was officially checked in.
Even on my last day, when I was wheeled down to get a final parting EKG, the woman who delivered me to the EKG area pulled a numbered slip and handed it to me. Only there was no number board to watch, just a hallway that apparently fills up with EKG candidates in our wheelchairs from time to time.
The best part of this story is this: After a few moments, one of the EKG room doors opens and an employee looks at me. “What do you want,” she asks. “Umm… donno, I’m just sitting here in this chair, parked where someone thinks I should be parked. Don’t you know?” Turned out I had been delivered without my papers.
She is our Problem Patient – The nurses on my unit briefed each other at the shift change by standing in the room and discussing the patient. On my second day, I was introduced as the “problem patient” which is probably fair enough most any day (not good at just taking orders) but in this case actually meant that I didn’t speak German well. Fair enough but does anyone else want to raise their hand for situations where words like Nadeln, Blut, Blutverdünner, come up in everyday conversation?
It is true that I was also a problem patient by getting out of my bed. At 3 a.m., when I was wide awake one night, I went for a walk up and down the main hall. Then I tried to ask for a tissue (Seidenpapier in case you are the night nurse) and got told Nein! Um, okay. Then I was at one end of my hall perambulate where there were some restrooms. I opened up one door, picked up a paper towel and started blowing my nose. That brought night nurse running. I believe he was trying to tell me that the restrooms were for staff only. By this point in time I really didn’t care. Problem child, always have been, always will be.
It keeps coming back to language. Like I should know more German. And its a big problem when I am in a medically vulnerable situation. Most of the time, I had enough German and the nursing/doctor staff had more then enough English that we did communicate on the necessary but the language barrier was tough and wearing on me. This is one of the challenges of expat life – the ever constant confrontation on communication.
You Do Have Your International Immunization Card, Yes? This is what set me off into a very deep grump, grump, grumpity grump on Monday morning, post hospital. We’re going to India in a couple of months. We need a few vaccinations – but its been so long since I’ve had any that I can’t really remember what I’ve had. And back home, the records lived with the doc. Which is not how they do things here. Like hospital breakfasts are not like what is served back home (tray with covered plate – lift the cover to revel 2 bread buns. Maybe some cheese if you are lucky. Yogurt on the side. Actually, not bad but another confrontation with the different when I was feeling vulnerable and craving the familiar).
So, the new general practice doc who is over all pretty good says to me today, “You should bring your International Immunization card” and then makes a great big German Tisk-tisk face when I fess up that I didn’t have any such thing. That face didn’t get any better when he suggested that I should just contact my doctor back in the USA. (Um… that would be plural and some of them are retired. I’ve moved a bit.) Today, this just pulled my expat chain. I’ve been threatening for a while to make a list of what should be in the briefing papers handed out at the immigration booth at the airport. And if y’all want me to be all neat and orderly and tucked in with some freaking vaccination registration then y’all should be telling me about this much sooner and with a lot less “fail” in your voice.
This is expat life. I fail. I fail on a regular basis because I don’t know all the thousands of ways things are done here. I look up washing machine manuals online so I can read the instructions in English and I don’t have to bug other people. I have learned to mark every no-shopping holiday (and there are many) on my calendar. I have dozens of ways to cope with this still strange new place and I still know I will continue to learn by failing first. Its just that today where I had to have to run again into the truth that I do not in fact “German” worth a damn was very discouraging.
Aside from the Cultural Conflicts… This German hospital took very good care of me. Many hospitals have body part specialties. This one, less then a mile from our home, specialized in hearts so they had the heart diagnostic/fix it process down.
1. The emergency room is called the Chest Pain Department. If you are rolling in the door on a gurney, you’ve got a heart problem which usually shows up as pain. The Germans use very practical words for most anything. For example, the German word for glove is Handschuh – hand shoe. I didn’t have pain, I had too fast and too irregular heart rate but they took me into the Chest Pain department anyway.
2. Doctors work for the hospital, and are usually rather young. They don’t follow you back out the door for follow up care and they seem to be there as part of their training and to see a lot of hearts in a hurry. Sometimes thats fine and sometimes, like when the first doc to see me ran the blood port into my left hand, he ran past the walls of my vein which ended up with one of the meds getting dumped into the flesh of my left hand. Which still hurts.
3. When you are discharged, you get enough meds to take with you to last until the first business day when you are supposed to hot foot it back to your regular doc and so you can get new prescriptions based on what you were discharged with. The hospital does not issue the script. Again – not like this back home where your doc sees you in the hospital. A friend said today, “I so surprised that you can get in to see a doc on the same day,” which is another one of the ways medicine is different here. Basically…show up.
That will be 30 Euros please We have public insurance. We pay ¼ of what we paid for insurance back home. Beloved’s employer matches our amount which means total cost is ½ of what we’d pay back home. When it was time to go, we asked if we needed to check out because most everyone seemed to say “here are your pills and your letter, bye bye now.” The answer was unclear (“um, we don’t do money”). It turns out that we just walk out. The hospital will send a bill for our three days of care for….10 euros a day. Also, you can order a taxi from the information desk.
We’re never coming back to the states.
So how is that Afib? Pretty good. The heart is still out of rhythm but not so fast. This makes the hospital docs happy. The personal doc wants the rhythm back too but that takes a little while to get going via drugs (if ever). One of the hospital docs said that rhythm wasn’t going to kill me as much as blood clots so we’re working on avoiding that. There’s a cauterization procedure for heart rates that the hospital does on a factory scale so I’ll probably end up taking that path in late January. It may not work. The important part is being able to walk, breath, sleep etc nearly like a normal person which is great!
No, really, how are you doing Anitra? Honestly, discombobulated. A little bit scared, this isn’t something I want to have right now or ever. My brain is recovering from all the drugs and anesthesia that was pored through my body since Tuesday a week ago which shows up right now as being both sleepy and memory/focus gaps. My capacity for accepting new challenges is significantly reduced at the moment, but new challenges come none the less. I have anger, usually aimed at innocent and inappropriate targets but really aimed at myself. I feel shame because my body is “weak” and I don’t know how to behave in this German medical system. (Yes, my standards for myself are way too high*).
Some of the procedures done to me while I was under mild anesthesia is being remembered by my body and I think the back of my brain. In truth, while these events were performed to re-create health and with my intellectual permission – getting zapped with a defibrillator is violent. When I got home, my body started remembering and by remembering communicating with me emotionally what all had happened. Its still talking to me and I’m still grieving. I think I need to go find some self-care soothing ways of being touched soon. A massage, reiki, I’m not sure yet. But I need to start offering myself some comfort soon.
In the meantime – I feel better, stronger, healthier. And very appreciative of German health care. It drives me a little bit nuts but 10 euro a day fixed up a lot of problem.
So… to be continued.
*Beloved, my first and best editor looked at this and said, “Yes, they are. You are way too hard on yourself”.