Friday, August 4, 2017

New shunt operation in the land of the half-assed way of doing things

I just came back home from my third shunt operation of the year (if memory serves). This time they fixed a narrowing of the shunt in my underarm by installing some kind of stent that widens it. One more operation is due, because now too much blood is flowing through the shunt. This time the operation wasn't as painful as the last time round and it seems everything to do with the operation went smoothly. It was over in one hour, with two surgeons operating. As usual I did this with local anaesthesia, but one of the surgeons warned me that they might have to switch to full anaesthesia if they had to go deeper into my body. Thankfully that didn't happen, otherwise I would have been throwing up all over the place after the op.

One thing that continues to annoy me is the sloppy attitude of German medical personnel. A previous time that I was admitted there, the person taking my blood let the bare needle fall on my bed and was about to put it into my arm before I stopped her and asked her to use a new needle.

This time (I think it is the same person, a doctor), the doctor just grabbed some hand disinfectant liquid that's available at the entrance of a room, and dabbed it on a cotton swab, and then dumped the cotton swab face down onto a non-sterile surface, the side table which had just had my lunch on it. Then she cleaned the spot she wanted to draw blood from by using this swab, using the swab's face that had come into contact with the table. In the meantime, she dumped two cotton swabs onto the table, and after drawing the blood bundled them up and put them on the spot on my arm that she had drawn blood from.  She's a doctor, she should know better than to take such a risk by not following protocol. I think it was the same person the previous time as well, I had thought she must be some rookie nurse, but now I think it was this same doctor. What she did was an improvement on another doctor at Charite who, back in 2011 or 2012, didn't even bother to disinfect my arm before sticking a needle in. I had complained about that to my nephrologist back then but my doctor just shrugged and said he knew that doctor at Charite, he had briefly worked for the nephrologist and been fired quickly afterwards from the dialysis center.

I notice this general tendency towards sloppiness in all of German culture; in this respect, Germany shares a lot with India. The way they run their trains (compared to Japan), the way they run their hospitals, telephone companies, universities, everything. Germany is the land of the half-assed approach. Germany does day to day bureaucracy well, but that's about it. They are good at being bureaucrats, they are not good at doing things right.

It is ironic to think that I survived years of dangerous medical care in Delhi, only to end up in an advanced western country where the same careless practices happen as back home in uneducated, underfunded India. It will be very funny if I end up being done in by German medical care, having escaped intact from India, although my wife and child will probably not see the humor in the situation.

Maybe all medical care is like this everywhere. It's hard for me to judge because whenever I go for dialysis to a European country or Japan, or the US, or southern Germany, I find superior adherence to protocol than I see in Berlin. Maybe it's a Berlin thing, perhaps we need a name for it. How about the "geht schon" attitude? I hear that phrase a lot when someone is about to break from protocol.

There is something I can do about this, however. I found out how to register a complaint to the hospital, and I will, and the next time I am going to be an asshole and tell the doctor to stop doing what she is doing and draw blood using the correct disinfection protocol. I was just not ready to confront the doctor this time, but next time I will be mentally prepared. I have to rehearse the language in advance so I don't insult them, but I still get the formal rigour that I want from them.

Shunt operation site.