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Berlin in Bed, or Three Cheers for Socialized Medicine

Most people go to Berlin for the café life, for the expat glamour and to see Brecht in constant repertoire. Others descend on the remnants of the infamous Berlin wall, now on the cusp of celebrating its first full generation of destruction and East-West reunification. Still others visit the shrines to WWII and their repetitive, repentant mantra:  “Vergesst das nie” (“Never forget”). Not me.

I went to Berlin to for the healthcare.

As in many bait-and-switch travel adventures scripted by Destiny, this was not my initial intention. My motivations were admittedly contrarian: I wanted to see my friend’s “Kleine garten,” a free plot of land which is every Berliner’s right as a citizen to lease, squat and settle; to swim in each and every of the green city’s huge lakes; and to reach each of these green (and blue) destinations by bike. I wanted to not speak about theater or the arts the entire time. I wanted, in short, to flee my city life for a more rural one. And I was going to the largest and arguably most cultured city in Germany to do it.

Two days before I left Brooklyn, something slipped inside my back. It was a subtle but seismic shift which, not exactly helped by my last minute packing routine, caused me to wake up unable to move. That day, I had an appointment at the NYU Medical Center for a foot exam (they say at 40 everyone falls apart, and I have always been precocious). My back was in spasm, and, as it took me a good 10 minutes to hobble from my seat across the waiting room and into the specialist’s office, I asked said specialist if he could prescribe some kind of pain killer as the next day I would have a long international flight. He declined, and told me to take some Advil. He spent under four minutes with me before sending me to the receptionist to sign for my bill.

My X-ray technician was more helpful. Seeing my struggle, he sent me down the hall to the reservationist hub for the Spine Center. When, 20 minutes later, I’d finally hobbled the 100 feet down the corridor, tapped on the receptionist’s window and explained my situation, she looked up at me with an amused glance:  “Oh, Dr X is a back surgeon,” she said. “Besides, he books up at least two to three months in advance.”  I don’t know if the closing slide of the window made me cross-eyed, or the pain of a sudden back twitch. I tapped again. When I emphasized my situation, including my upcoming flight and the fact that I was traveling alone, she took pity and gave me the name of another doctor, this one the pre-op doctor who I would have to see before I could see the main specialist. But, she explained, there was an even greater demand for him. “He has to screen all the cases for all the surgeons. You won’t be able to get in to see him for at least four months.” “Then what do I do?” I asked, sincerely hoping for some deus ex machina to descend and address the absurd question of how I could possibly expect to get my back checked out and medication prescribed while in the NYU Spine Center. “Do you know of any, just, you know, back doctors?”  She smiled at me dismissively as her eyes and the wall between us once again turned to glass.

And so it was that I hobbled around the corner to CVS, bought an enormous bottle of ibuprofen, went home, lay on my back and, in my own agnostic last resort manner, prayed. And so it was that the following day, I made my way to the airport, pumped myself full of over-the-counter drugs, and amply enjoyed the generous open bar of my Lufthansa flight, explaining the situation to my prim yet compliant stewardess—“Is that enough gin?” she asked, as she filled my paltry translucent plastic cup, “I don’t drink. It’s bitter.”  “Well, I do,” I said. “Double it.”  Then grimaced, pointing to my back and feeling like an 80-year-old acerbic literary alcoholic or Dorothy Parker just before she stopped giving a damn.

And so it was, I arrived in Berlin.

For a couple of days, I shuffled around, trying to be a good guest and seeing what I could, my dosage of ibuprofen increasing in direct proportion to my cocky confidence that “daily maximum dosage” was a recommendation for mainstream tolerance and not a tough gal like me. On the third day, after 30 minutes of unsuccessfully trying to get out of bed, each time slammed back down with a surge of pain that made me weep, I took six Advils with water (and nothing else), and lay waiting for them to kick in so I could rise without assistance and my self-respect intact. Eventually, I rose, but within 10 steps, I had broken into a cold sweat, and my heart started racing hard and fast, as the pixels of color that made up the room began to bleed swiftly away to a blinding white. As the room disappeared and I began to pass out, my friend found me, my complexion now the same color spectrum as my vision.

And so it was that I met Dr. Prost. This is his real name, though for reasons of anonymity I will not mention his first name. Prost, of course, means toast! in German. Kampi!  Cheers!  Bottoms up! It means alcohol, and alleviation from pain and suffering. So Prost in fiction as in reality he shall remain.

Dr. Prost was the physician sent to me by Germany’s emergency healthline. And how he got there was this: When I began to turn cadaver-white, my friend had promptly called the number. While she was still on the call, I’d taken some food and the results of a clear ibuprofen over-dosage had mitigated. It was not an emergency, but there was cause for concern. Based on this, the center sent us (Prost!) the doctor.

He arrived like a socialist angel, bedecked in jeans and a fleece, tall, gaunt, and handsome (just my type), speaking perfect English, and gazing into my eyes with focusing directness. “How are you?”  He asked. “Oh, I’m okay,” I replied, my chin raised with my best American optimism. He gazed down at me, laying there on my back, unable to move, just a shade more colorful than the sheets, and chuckled. “I don’t think so,” he said wryly, making me laugh, too, a relief that promptly sent my back into deep spasm. When I’d recovered, he asked me a series of thoughtful basic questions. He stroked my leg to determine sensitivity (“higher,” I wanted to joke, not yet quite clear on the pulse of German propriety and humor), then checked my reflexes, which caused my foot to flail up and kick him, sending my back into spasm once again. “Sorry,” he said, “I didn’t mean that.”  “Neither did I,” I replied, remorseful of my involuntary response.

I explained I’d been swimming in the lakes. He said with old world politeness that this is a delightful thing to do. I further explained that I felt that led to my relapse. He replied, with German rigor, that swimming is the best thing I could do for my back. That I must not enfeeble myself, that I must move. And that to stretch my spine, I should perhaps do the…(he exhibited back stroke), as opposed to the…(he exhibited overhand). He said that he would prescribe me something to ease the pain first, a little something that he introduced with a slightly wicked smile as “morphine’s little brother.” He said that it would make me happy. And that it was slightly addictive. And that the price being the same he would prescribe me 50 pills instead of the 30 that would surely be enough. And that I couldn’t drink alcohol while on it. But—that I wouldn’t need to.

My friend asked Herr Prost what he thought about a steroid shot. He considered the suggestion, explained that this was for long term healing, not immediate relief, but that it was nonetheless a good idea. He rolled me over and gently complied. He then answered several small specific questions I had been hanging on to since NY (including just how much Ibuprofen one could safely take), and with a smile and a friendly handshake, left me with a prescription and relief that what I had, though painful, was not an extreme injury and would heal with time and drugs and as much movement as I could handle. And with that, he disappeared again down the rabbit hole of my friends’ West Berlin apartment, and into the waiting car below. In all, he had spent 20 minutes with me, answered all my questions, eliminated possibilities of extreme injury, left me with a prescription, a shot and a bill for 90 Euro, not accounting for any medical coverage. (The meds would later cost me an additional 40.)

Prost also left me with ideas—beyond simply whether all German men were so gentle, thoughtful and capable. When was the last time we had a house call in the United States?  And just how far would 90 Euro (roughly 135 USD) get me after waiting seven hours in an NYC Emergency Room without health insurance?  And why couldn’t the kindly folks at NYU Medical Center lift their gaze just a touch higher to help me find a professional who could take me in and ensure the preventive measures that would have kept me from landing in Berlin in such a mess to begin with?

I’m not a policy expert, nor did I intentionally go to Berlin to descend under cover/s. I’m just a poor playwright with a corporate bread and butter job which is about to end, leaving me precipitously close to the healthcare void.

Germany has the oldest national healthcare system in Europe, established before insurance companies could attain an unhealthy bloated girth in that country. Switzerland sports another example (I have been to the emergency health clinic there too—excellent and cheap). Long lines?  Compromised services?  This is not what I experienced, in my random sampling of services. Sure, they pay for it, as the argument goes, but so do we—and we certainly pay for it when we don’t have coverage. As for Dr. Prost, he was not a specialized house call doctor. He had a regular practice in the north of the city, but the day of my encounter was his routine rotation on citywide duty. Based on his kindness to me, my friends took his information, with the idea that they might have just found a good reliable new primary doctor of their own. That’s a win-win, in my book.

So. What did I learn on my summer vacation? If socialism means prudently dispatched home service. If socialism means civilized, focused care and universal coverage—by doctors who are just slightly more compassionate than they are wealthy. If socialism means being able to recover on my back in a kleine garten under a plum tree heavy with fruit, as vegetables grow around me. Then I raise my glass, and I say: Prost!  May I someday see him again, and this time, in my own Brooklyn bed.


Emily DeVoti


The Brooklyn Rail

OCT 2009

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