Monday, January 24, 2011

"Part of Your World": Hannover , Bad Oeyenhausen, and Vienna General Hospital
















Nürnberger Rostbratwurst at Pfefferkorn and New Town Hall (Hannover).


I made it through the night after getting back from Munich and fending off Katie rolling on top of me, and started my time in Hannover at the doctor's. Nils took me to a practice a block or two away from our hotel first thing in the morning, where we sat and waited and people-watched for a bit. As people walked in, they'd greet or be greeted with a dreary "Morgen", which I thought was funny since Americans in waiting rooms generally ignore each other unless someone steals your magazine or catches on fire. I felt like I was in an authentic German scene for the first time on the trip - it's hard to get a feel for some of the smaller aspects of daily life when all you're doing is touring, eating (drinking?), and staying in a hotel. And when we travel, it's typically in a conspicuously large American group, which sort of deters normal interaction. There were all types of people in the room with us: young and old, punk and hipster, flirty, scary, and what have you. Your typical waiting room collection.

When I went in to see the doctor, I skipped the nurse step - I gathered that was normal, though, unlike my experiences with American places that send in a nurse to see you first. No vitals, no bonus wait-to-see-the-doctor time in between. The doctor I saw spoke English, and I think he spoke it well enough, but he obviously preferred German since that's what he ended up talking in for most of my visit. I felt comfortable enough having a translator that I trusted, but it was certainly different needing someone else to speak for me. Also, his office was half examination room and half ... office, complete with his desk and computer and everything.

At the pharmacy (apotheke), it once again would have been helpful to speak more German. I got instructions on when to take everything and the basic idea of what I was taking, and for the first time in awhile didn't know exactly what I was taking, but just followed instructions. I guess that had been the case with the over-the-counter drugs from Göttingen as well.

I met up with the rest of the group at the cattle clinic after lunch, and I think that was the first time I'd had to navigate completely alone during the whole trip. Barring the couple of times I checked my rail map, I felt a lot less conspicuous than when I was with the entire group. Aside from the fact that I obviously don't look German, maybe other people noticed me a little less.

The cattle clinic was interesting, if a tad smelly, but it wasn't my cup of tea. (And I had a lot of those during the time I was sick.) I'm glad I got the chance to go. For one, now I know one of the ways they get cattle to ... make more cattle, shall we say.

Afterwards, I trailed Dr. Wasser and Lina back to the hotel. I made a stop in the Leibniz store for cookies and such, then popped in the grocery store for tea. In a weird way, I really like going to foreign grocery stores. It's like seeing a cross section of their daily consumer lifestyles. What would it be like to actually live in Germany and have to shop for groceries? We were too mobile on our trip to make any grocery runs; we just ate out every day.

The next day, we made a trip to Bad Oeyenhausen to the heart center. As badly as I wished I could have seen a heart surgery - and they were surprisingly going to let me - I took both tours instead, which was probably the wiser choice as I wasn't far from passing out even in the absence of a bloody OR. I guess it speaks volumes for my biomedical engineering aspirations that I didn't know artificial hearts even existed. I honestly got a little lost during some of the tours/lectures because I don't know much about hearts yet, but Physio II will fix that.

Sadly, that night we had say our goodbyes to Nils and Lina, since they were returning to Bonn. I think it's fairly obvious on our part that we adored them both and were disappointed to see them go before our program finished. It was a blessing to have young people to help us during our experience in Germany, and I owe it to Nils for putting up with us for two weeks and letting us follow him around somewhat cluelessly.

We took a night train to Vienna...an experience in itself. As crammed as we were, I thought it was comical. Our group got three compartments, each with six beds and maybe five square feet of floor space, which was a physical struggle with our giant packs. If it hadn't hurt me so badly to sit up and down, it would have been loads more entertaining and restful. We got breakfast in the morning before we arrived in Vienna. On a related note, European breakfast just doesn't do it for me. I'm looking forward to American breakfast when we get back. Bring on the coronary artery disease.

So that brings us to Wednesday morning in Vienna. Kate and I dropped our stuff at the hotel and went off with Rainer to a hospital. (I hadn't been improving as I should have and was in a lot of pain and wound up in the Viennese ER.) As there was only one of Rainer, I fended for myself for the first bit. Although the doctors spoke good English, but the receptionists, technicians, and nurses didn't, and surprise, they don't take foreign insurance. I'm glad I had a credit card on me; my debit wouldn't have been close to covering my costs. Having HTH is great, but I had to have the money to spot it.

I was actually scared, sitting there by myself in a Viennese hospital on a pain drip with a needle stuck in my arm, waiting on x-ray and EKG and blood results. I got my first CT scan and experienced some of the contrast dye reactions that we'd talked about in Physio I last semester when learning about coronary angiograms. Also, I couldn't put my finger on it at first, but it was weird that I didn't put on a single gown during either of my medical visits. You remove some of your clothing, but you don't get any bonus clothing, either. I have a funny feeling that Europeans are more comfortable with that than we prudish Americans are. Nude beaches still a nay over here.

I used to get some of the imaging techniques mixed up (although I was able to successfully tell Rainer what CT stood for...woohoo), but that's one I won't forget. In fact, going to the hospital was one of the most relevant non-program activities I could have been doing, especially given that I'm a biomedical engineering major. I watched the busy Austrian Red Cross bring people in and noticed that some of them were quite young. Later, some of our Austrian acquaintances, Robert and Christian, told me that it was an alternative to the military time required of young men. Also, since I was there from 10 to 4, I noticed that the ER traffic spiked around the afternoon. Probably not unique to Vienna, but I've never been in the ER so long and had the chance to watch the ebb and flow of people. I saw two men greet each other with kisses on the cheek - something I'd always heard about but never really seen, and definitely don't think I'd see in the States. I also saw a group of students collecting in our area. I'm not sure if they were medical or not; they looked like they could have been students like us (not in medical school yet, but in the field).

I missed the city tour, regretfully, but I feel like I sort of subbed the experience for something else. The unique experiences of a few days - the doctor, the hospital, the grocery store, the pharmacy - and having to get myself from point A to B gave me a little sample of things that a native German or Austrian might do.

To digress: I have a completely different perspective on the language barrier as a barrier to healthcare. In my Health 236 (Racial and Ethnic Health) class last fall, we learned about the health status of various minority groups. For several of them, such as Asian/Pacific Islander and Hispanic, the language barrier negatively impacted overall group health. This was all understandable in theory, but I truly empathize now. I felt like I didn't know what was going on even when the doctor spoke perfect English to me, because the other technicians, nurses, and receptionists barely know enough to do their jobs without moving me around themselves. I think I put more blind faith in than usual as it was just too difficult to be totally informed. I'll be more understanding when people struggle with English, as it's been humbling to know my ineffective communication wasn't simply due to a lack of intelligence. I probably seemed more lost than I normally would have been in an American hospital or radiology center; because I was having to devote so much of my energy and attention to communicating, I did other absent-minded things, like take five minutes to figure out the credit card machine.

Within our particular program, we 're more sheltered than I realized from true culture shock. The illness wasn't fun, but I count the experience as a bit of a blessing after some of the feelings it put me through.

"And ready to know what the people know
Ask 'em my questions and get some answers...
...Wish I could be
Part of that world."

- "Part of Your World", The Little Mermaid

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