Examining the German Healthcare System

The next day dawned cold and rainy. We had been lucky this far, as every day the forecast predicted heavy rain, but except for a sputter or two, it had not materialized. It finally crashed in on us. We were scheduled to stop at Wertheim, for a walking tour, ending in a bus ride as the Vali would continue on and we would meet her later. But I recognized the beginnings of what appears to be one of those annoying functions of aging: a urinary tract infection. My mom used to suffer with these, so I work hard to stay hydrated and follow all the usual advice to avoid them, but the symptoms are unmistakable. I always carry a medication to reduce the burning, but the only real solution is antibiotics. On a large cruise ship, there is always a doctor, a PA or an NP available for these minor issues, but not so on a river cruise. Since the weather was awful, we resolved to remain on the ship, and take the day easy in hopes that I could flush my system and nip this in the bud. But by morning it was clear that I was feverish. Not wanting to progress to a kidney infection, I decided to explore my options.

The young lady at the customer desk informed me that my hope of finding a walk-in clinic in our next stop was a no-go. And physician appointments take weeks to obtain. So, my only choice was a trip to the emergency room of a hospital. In the US, of course, going to an ER for such a minor problem would get you several hours of waiting to be seen. But not so in Germany, apparently. I was told I could get a cab to the ER in Koblenz, our second stop of the day, and spend no more than an hour to be treated, returning to the ship in plenty of time.

So, in late afternoon, Bob and I jumped in a cab and proceeded to Kemperhof Koblenz, billed as the 4th top rated hospital in Koblenz, a city of 112,000. I didn’t know that at the time. Our first challenge was language. Most of the intake people spoke only German and we had a few tricky moments trying to figure out how to even get started. But when I uttered the magic word, urinary, which is the same in German, I was directed to the urology department of the hospital.

The Urology department seemed deserted, but we found a guy who directed us to an exam room. His name badge was turned so I wasn’t sure what his title was, but he spoke English, which was a plus. He prepared an exam table, took my information and passport, made a copy, then asked me for a specimen, which I happily provided. He came back a few moments later and told me I had an infection (no kidding) and that the doctor would be in within the hour. It was only a few moments later when Dr. med Ludger Franzaring, Facharzt (specialist) fur Urologie came in. He spoke English as well and asked me to climb up on the table so he could examine me. He did so and proceeded to give me a pelvic ultrasound as well. Apparently, I have a renal cyst, which he suggested we check again in a year, but finding nothing else of interest, he ordered an antibiotic and some pain medicine, and directed us to the business office for payment.

At this point it was nearing six pm, which is when we were told the nearby apothecary would close. I left Bob to hang out at the business office, which was confusing and disorganized and seemed to function as both a business office and a triage area, as people were coming in and being assessed. I headed over the three blocks or so to the apothecary. English wasn’t their forte, but we got along well enough, and I headed back to the hospital to pay the bill. I wasn’t worried because we had trip insurance, although we would have to pay up front, and the ultrasound threw me, as those are expensive in the US. It was dark, raining and because the streets were unfamiliar to me, I was holding my phone tightly in my hand and following GPS.

In the US, most curbs are either painted to reflect their presence or are a lighter or darker color than the surrounding pavement. This doesn’t seem to be the case in Germany. And I missed a step. I went down like a brick, making a stunning three-point landing on my knees, my wrists and my face. Since I hadn’t seen it coming, I was momentarily shocked. Thanks to the adrenalin, I didn’t feel much, and I do recall exclaiming the big F rather loudly. But when I got up, I felt pretty dizzy. My biggest fear was to pass out in a dark, wet parking lot, since Bob wouldn’t know where I was, and there was no one around, so I pulled up my big girl pants, and made it back to the hospital. My watch, ever vigilant, noted that it was prepared to call an ambulance. I walked in and told Bob tearfully, that I had fallen, and then noticed that my right thumb was bleeding all over the place. Apparently, I had instinctively protected my phone and somehow avulsed my nail bed on both sides, leaving my thumb resembling raw meat.

There was a silver lining though. Not only did I have the medication I needed, but the hospital told us we didn’t owe anything. Not one pence. I have no idea how that works. Maybe it was just too big a pain to figure out the cost since my understanding is that Germans pay little to nothing for health care beyond their taxes. So, we called a cab, headed back to the Vali, and I was left with a weeping thumb, sore knees and wrists, scratched glasses, and a terrific black and blue chin. I’m sure some of the guests questioned Bob’s mild-mannered persona for the remainder of the voyage.

But the UTI was under control.