4 weeks in Europe (so far)

I decided on Europe for part of my elective pretty early on, as I had no previous travel experience and have always wanted to see castles in Germany. A friend was put in the same quarter, so we decided to go together. We applied to a few different hospitals and decided on one in Cologne, Germany. I'd learned some German a few years earlier and hoped that brushing up with Duolingo would dust off the cobwebs. 

As we technically had two weeks off for Christmas, we decided to utilise this time for travel and exploration of Eurpoe. The plan was:

• One week to get to Colgne and settle in,

• Six weeks of hospital on weekdays,

• Travel to different places on the weekends, and 

• Then a week at the end for more exploration until we fly home from Vienna.

So after arriving back in NZ from Samoa on the 28th, I repacked my bags for winter, said hi to my Dunedin friends, and flew out on the 30th of December. After 36 hours of traveling we arrived in Cologne and found the Airbnb we had booked for seven weeks. 

Arriving in Cologne in time for New Years

We could not have timed it better. New Years Eve in Cologne is a fireworks display that starts in the streets as soon as darkness falls. People just lighting rockets everywhere, no concern for surrounding buildings. We went for a walk to the Rhein close to midnight, and it just got more and more stunning the closer we got. The riverbank was crowded with people both lighting and watching the fireworks. No officials in sight, just people celebrating life. 

We spent the rest of the week exploring Cologne and catching up on sleep. We discovered that residing in Germany, even for only two months, requires a lot more paperwork than the Pacific Islands. We also found the best commuting system ever and an amazing doner kebab shop, just down the street.

Starting off in radiology

We met up with our supervisor on the Monday after we had arrived and he showed us around the hospital and introduced us to the radiology professor, whose team we would be joining for the first two weeks. We officially started on Tuesday. The day starts with a 35 minute commute to make it to the 7:45am meeting. The doctors often speak in english when they talk directly to us, but when they are discussing clinical matters with each other, or just having a yarn, they generally switched back to German. This was somewhat of a trial by fire for me as I quickly realised my conversational German is very limited and medical terms here are generally quite different as well. 

In that respect, radiology was a great way to start our placement here. Not only were we able to get better at interpreting imaging, but we also learned a fair amount of clinical vocabulary. I get home at the end of the day mentally exhausted from listening and trying to understand a new language. 

Exploring the sights of Europe

Our second week in Germany we were too tired to go very far, so we stayed in Cologne and went to the chocolate factory. It was amazing. Then on Sunday we took the train to the city of Aachen. It was stunning. 

After two weeks of radiology we went on a weekend trip to Bavaria. I finally fulfilled my dream of visiting Schloss Neuschwanstein: the castle from the movie, Chitty Chitty Bang Bang. We spend a few days in Munich exploring before returning to start our ICU placement on the Tuesday.

Making the move to ICU

The ICU doctors are lovely. One of the registrars in particular, has been great at keeping us aware of any interesting procedures and explaining concepts in English. Most mornings, before the night team leave after handover, the registrars have breakfast together. We were invited to join them. It is a great way to start the day. After that the Chefarzt (chief doctor) arrives and ward rounds start. Often, we are joined by a cardiology consultant. Tuesdays are grand round, and the chief cardiologist comes as well. 

Most of the patients are intubated so for us patient contact is mostly limited to examination and observation of procedures. We have been told that a lot of the older generation of Kolnischers only speak the Kolsh dialect of German, which can make it difficult for doctors from other regions of Germany. There is also a large Turkish population in this part of the city.

The trouble with language barriers

On our first day we admitted a patient from the dialysis unit, with acute delirium. He didn't seem to understand what was going on and someone mentioned that he only spoke Turkish. Apparently he had been getting dialysis when he started ripping out the lines and behaving abnormally. It was the first time I've seen a patient be strapped to a bed. He was desaturating and required oxygen. Once he was a bit more calm (with pharmaceutical help) he was discovered to have bilateral pleural effusions. Over the next few days the decision was made to intubate, as he continued to desaturate with non-invasive measures, despite draining the plaural effusions. Other patients since then have required restraints, but with him I couldn't help but imagine being in his position and wonder how scared he might have been. 

Other patients in the ICU included people recovering from heart attacks, these we were able to stumble through simple requests in German so that we could examine them and practice using the ultrasound machine. The cardiologists also invited us to the cath labs, and I was able to watch ablation therapy for the first time. Another patient had abnormal liver function tests, so we went with him to ERCP and saw a gall stone removed. 

Travelling, exploring and Beethoven

Our next weekend trip was to Belgium, where we visited three cities in two days. 

After our second week in ICU it was my birthday so we took the Friday off and went to Bonn for the day. This is the birthplace of Beethoven, and there are commemorative statues all over town. 

Then on the weekend we visited Heidelberg. Inside the castle there was an apotheke musuem, which told the history of pharmacy in Germany. 

Just a few more weeks to go...