The Resort Doctor

In a previous post, I shared the challenging experience of being ill and going to a Company Doctor in Germany.  A couple of months later, while on vacation, I had a decidedly different experience going to a resort doctor on Rangali Island in the Indian Ocean.

It's about the halfway point on our holiday in the Maldives, and we had already been scuba diving six times and snorkeling just as often.  We had two dives scheduled the next morning (that were great).  After lunch we sunbathed and went into the gorgeous pool.  Later in the afternoon I went snorkeling for an hour to do some tests with Frau A's 10Bar underwater housing & her Panasonic LX3.  By this time, my ears had had enough water -- and became infected.  You've probably had swimmer's ear:  sore to the touch, swelling makes everything sound like it passes through a foot of cotton...

I was hoping to dive some more, but also wanted to have my ears back to normal before flying 4 hours to Qatar and then another 5+ back to Munich.  Luckily, the Conrad has a small clinic on site.  It makes good business sense for them.  They have 350+ employees that live and work on the island, and it's expensive and time consuming to take a water plane back to Male.  Guests can use it too.  So I stopped by.  Here's what it looks like:

In a paradise like this, you're already feeling better just walking up.  Soft, white sand paths lead almost all the way up to the front door!  The glass etched sign also communicates modernity, so you have confidence too.  Frau A noticed that the M.D.'s flip-flops outside the door were labeled "doctor" (pic below).  Cute.  And who wouldn't trust a barefoot doctor?  You, the doc, and his assistant are all barefoot inside to keep the sand out.

I had to wait about 6 minutes before the doctor saw me.  The doctor was polite, looked at my ears, made the obvious diagnosis, and immediately prescribed antibiotic ear drops, which he handed right to me.  No trip to a pharmacy.  Unfortunately, I was not allowed to swim, but Frau A did some more snorkeling and underwater photography.

Two days later, the ears weren't much better, so I visited the doc again.  This time there was a 14 minute wait (one person ahead of me).  He checked things out again, was unhappy with the progress, and handed over full antibiotic pills.  All of this at no charge!  He said it didn't make sense to mess around, especially since I was flying in 48 hours and the initial treatment didn't work as expected.  Sure enough, it worked.  He was fast, polite, and practical.

We loved the time on Rangali island, and give kudos also to great service by Conrad's on-site doctor!  Now it's back to work, and I'm gorging on vitamin C to avoid the company doctor this winter...

The Company Doctor

At times, the cultural divide between the U.S. and Germany can be amusing, frustrating, or just plain interesting.  Recently, however, I felt like it could almost kill me.

There is a distinct cultural difference about how to deal with an illness – specifically, going to work and going to the doctor.  At least in my experience, workers in the U.S. show up for work when they are moderately ill.  You don’t want to spread the illness around, but you do duty and try not to burn sick/flex days.  Plus, you figure that you’ll probably shake the bug in a few days and tough it out.  If you don’t get better (or possibly get worse) over a few days, then you might take a day off and probably go to the doctor for some medicine.

In Germany, the orientation is completely the opposite.  If you are feeling the slightest bit unwell, by all means stay home from work (or go home early).  Call the doctor immediately and get an appointment… because he/she will give you a written order stating you must stay home (legally binding, and probably adds an extra day or two) and you can make sure the Black Plague has not returned.  I would love to see statistics on sick days taken between the U.S. and Germany… but Spiegel.de does have a funny take on the matter.

“Unable to Work Certificate” that German doctors sign for workers

Backtrack:  Frau A and I cooked dinner for German friends last weekend:  my colleague, his wife (expecting twins in November), and their 3-year old daughter now in “kindergarten”.  The little one, of course, is bringing home all sorts of new and exciting colds from the other kids, and I caught something.  No problem… just hang in there a few days and get through it.  I chugged water, downed lots of vitamins, and got to bed early every evening.  Nonetheless, after three days my chest was still really tight and I had one of those coughs that completely prevent you from sleeping.  I got 2 hours sleep for three straight nights (and was tortured by German late night television, so started a new book).  Not getting better, I went to the doctor on the Siemens campus.  Enter the cultural divide.

The doctors assumed that I just started experiencing the symptoms.  So their recommendation?  Sit ten minutes with an infrared lamp (looked like a radar gun) heating my chest and neck.   See my Blackberry photo below.  You can see the infrared lamp, the timer bar to the left, and the red glow on the wall and chair!

Infrared light treatment 

After the “infrarot-therapie” I spent another ten minutes inhaling steam from a mask connected to something looking and sounding like an aquarium pump.  It emitted Darth Vader sounds, which were pretty cool.

Inhallation treatment 

Then they gave me a couple of throat lozenges, smiled, and said “see you tomorrow for more infrared and inhalation”.  Huh?  Going on a week of an illness that was NOT getting better, I wanted some real medicine.  I realize these are legitimate treatment options, but not in this situation IMHO.

So I tried one more night – the “treatment” had no effect, of course.  No sleep at all.  So I went back again and they offered more French-fry lighting and the vapor-inhaler-thingy.  I complained, but they were adamant that you apply homeopathic remedies first.  I complained louder (Germans always say no at first – keep trying) so they relented a bit and gave some prescription medicine to help the coughing, but would not go to antibiotics.

Let me say more directly – this is the difference between what I got, and what I wanted:

Hint for readers under age 30: "Aloha, Mr. Hand"

So I will head home again tonight and hope this works.  If not, then tomorrow they will (hopefully) prescribe antibiotics.  If I had gone to the doctor on day 1, things would have worked much better.  There are, of course, some German doctors that will take more aggressive treatment, and I’m not saying that the U.S. way is better.  You just need to understand a system to be successful in it.  Hope I survive another evening to try again.

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It is now two days later, and things are somewhat better.  The stronger medicine to loosen up the chest and stop coughing was pretty good, so they think I’ll get through without antibiotics – but they admit that it would be totally gone by now if they had prescribed them right away.  Good enough to actually look forward to the weekend. 

Also, I did a little research and the steam inhaler and infrared light are legitimate therapies… I guess I need to learn to start these right away to try and prevent whatever bug from getting worse.  But guys are never that logical.

It appears that I am not the only one with interesting experiences with Germans and illness:

-   Germans can “schedule” their sick time

-   UK averages 7 sick days per year compared with Germans averaging 8.4 (20% more)

-   Germany are getting more clever and having doctors keep them away from work due to stress

One more cultural learning:  when I’m ill and really need to sleep, I turn to Nyquil (and take more than the recommended amount).  This is not available in Germany (the equivalent is prescription) so I always return from the U.S. with at least 2 bottles, hoping they will last.  This time, of course, I ran out.  Frau A recommended the “southern Nyquil” elixir, that comes in various forms:

           

I must admit this concoction did help.  I see it on the Web with Jack Daniels or Makers Mark, and I would guess SoCo would work too.  Unfortunately, I had left my scotch at Frau A’s place – we had a scotch tasting with some friends and I never brought it back.  So I turned to cognac as the base, and it went down quite smoothly.  It’s not a pure cognac:  the Remy Martin website describes Coeur de Cognac as an “elixir” with essence of apricot and pear.  Works for me.  I’m not a huge cognac drinker, but this is a good middle ground and I like it even when not coughing up my lungs.  Give it a try.  I did try it with traditional German/Austrian schnapps, and recommend against this alternative unless you have a titanium esophagus.  Schnapps in Germany & Austria is NOT like that in the U.S. – no sugar added at all – this is on the back burner for another post… until then, “gute Besserung”.