Monday, February 13, 2023

Dentists and Doctors in Deutschland


My humblest apologies for the abbreviated post last night. I expect it will happen sometimes that I have less time, or less enthusiasm than normal when it comes to keeping up posting. I am only human. But to make up for it I'm writing today when I'm free and recharged on a full night's sleep. The day is still largely ahead of me and the weather is grim, but I'm chipper. Maybe because Asia is here. It's nice when a woman is around. They bring a different energy, enhance the Feng Shui. My apartment becomes a multicultural remote meeting room space where English, Polish and German perfume the walls. 

I have a dentist appointment later today. The appointment was made a month ago. That's how long it takes to receive medical care here in Deutschland. At times I truly wonder what the benefits of this 'universal health care' are. Sure, there are the obvious benefits, notably not bankrupting yourself over a costly medical procedure or a life-threatening condition like costly cancer chemotherapy treatments, which is certainly nothing to scoff at, but that's about it. The other misleading thing about the term universal health care is that it implies it's free. It isn't. You have to pay for it, and it's illegal not to be insured. So it's effectively the same configuration as in the US: you either split the bill with your employer, or you pay out of pocket if you're unemployed. The level of care I receive when going to a doctor here compared to the US is night and day though. There's no bedside manner, the doctors are all slammed, you're always waiting even when you have an appointment, the doctor spends a few minutes with you before rushing you out the door, and you never quite feel you've gotten the treatment you need. The worst of all though is the scarcity of appointments. 

When I first arrived in Berlin, nearly five years ago to the day now, I was having some stomach problems. Not a surprise for me, given my lifelong issues with GERD and acid reflux, but this time I was having some unique pain and discomfort I hadn't experienced before. Maybe an ulcer, I thought. Ulcers can be life threatening, so it's good to get a prompt diagnosis and take steps to treat it before it progresses to a worse, more serious state. In Germany you can't just go see a specialist, you first have to go to a primary care doctor. This, I think, is not so different than in the US (but honestly I can't remember for sure). After seeing this initial doctor, the appointment having taken several weeks at minimum to secure, now, armed with your referral, you can embark on the journey of finding a specialist - in my case, a gastroenterologist - who could perform the necessary examinations. I would need an endoscopy and a colonoscopy to inspect the entire length of the GI tract. I've had quite a few endoscopies before, as is common with my condition, since they need to monitor your tissue and check for mutated cells. The acid has a damaging kind of carcinogenic effect on the esophagus which, over time, can trigger a condition called Barret's Esophagus. Esophageal and stomach cancer are notoriously difficult to treat and also painful, so preventative care and early detection here are key. Needless to say, I've had my share of endoscopies, so I expected the normal walk in the park you might associate with taking your car in for a quick routine inspection. I went for the consultation with the gastro, and he confirmed I'd need an endoscopy but also recommended a colonoscopy since I was nearing the age where I'd need one anyway. Great, I said, let's get it done. When can you do it, I asked, two weeks or so? The doctor looked at me as though I'd said something outrageous. Oh, no, you have to make an appointment and it can take some time. Okay, I said, so, what, like 4 weeks? He seemed impatient with my questioning. Please speak to the nurse at the front desk and she can arrange the appointment. Okay. When I went to the nurse she told me the next appointment was 7 months away.

Seven months.

I was dumbstruck. She couldn't be serious. If there was some problem that needed urgent intervention, like an ulcer waiting to rupture, for example, I could be dead by then. I implored her, asking if it were possible to get an appointment sooner than that given I was experiencing acute symptoms. No. 

You can imagine the rest of the story. I had to wait. 

Luckily it didn't take quite as long as they said due to someone canceling their appointment and me being able to take their place. I think it wound up taking a month or two, but I can't remember now. 

I'm suddenly getting the feeling I've told this story before. I hope I didn't because then I'm repeating myself. I'll check back after I post this and maybe I'll owe you another apology tomorrow.

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