Dr. Volts and the terrible, horrible, no-good, very bad Germany trip
Things did not go as planned.
About a month ago, I told y’all that I was traveling to Germany and Denmark with Mrs. Volts. I solicited your suggestions. l promised you some podcasts. So it’s only fair that I share what happened on that trip, from which I returned just a few days ago.
Friends: it sucked.
(To be clear: there’s nothing in here about clean energy. There’s no real reason for anyone else to be interested, other than morbid curiosity. Feel free to skip it! I need to document it for myself, while it’s still fresh, and I want a place to point everyone who asks, so I don’t have to tell the story 100 times.)
Our flight had a short layover in Paris before reaching Hamburg. About 20 minutes before landing in Paris — after nine hours of otherwise uneventful flying — I started getting stomach pains and broke out in a profuse cold sweat. Then I thought maybe I felt diarrhea coming on? Or was that puke? It felt like everything was going wrong in there at once.
We thought it was food poisoning.
After what seemed like an eternity, we deboarded and I raced for the first bathroom … where nothing happened but more pain and cold sweat. I hobbled with Mrs. Volts into the passport line, more or less doubled over, and waited, and waited, and just as we neared the front I had to bolt out of line for another bathroom. Again, nothing, though this time I did puke up a little bile. I just sat there, hurting and clammy, until the only thing that made sense was to lie down on the bathroom floor. (Not my fondest memory.)
Mrs. Volts had gone ahead to look for medicine. I finally crawled my way out, through the passport line, through the customs line. She and I met at the gate to Hamburg literally as they were closing it. As they were scolding us for being late … I puked some bile into their little trashcan and we hurried on board before they could say anything.
Same clammy, intense pain for the hour-long flight. I kept puking into the bag, but there was no substance to it, just pale-green bile. (I kept thinking, if it’s food poisoning, shouldn’t I be barfing up the offending food?) We finally made it out into daylight and got a cab. Luckily Mrs. Volts thought to bring the spare airplane puke bag, because there was more puking in the cab.
Finally got to the hotel and spent a night in feverish, painful half-sleep. The next day — Sep. 12th, my birthday! — Mrs. Volts left to attend her morning work events and I scheduled an online consultation with a German doctor. (It was absurdly easy and cheap to do so.) That doctor told me: you should probably go to urgent care. Which, as loath as I was to admit it, made sense.
So, Mrs. Volts came back and we went to the Hamburg University Hospital ER around 2:00 p.m. We stood in line for six hours (well, she stood, I sat doubled over in a crappy chair) before even speaking to anyone. Then they whisked me to a different waiting room, stuck an IV in my arm, and we waited for 2.5 hours more.
Then, at last, a bed, and a few short hours later — right around midnight — an emergency appendectomy. Happy birthday to me!
Friday was a a bit of a haze, but all things considered, I felt pretty good. I mean, I hurt like hell, but pain feels very different when you have some reasonable expectation that it’s going to get steadily better. (People who have been through medical stuff understand that uncertainty is the worst; it amplifies every bit of physical and psychological pain.)
The extremely good news was that the appendix had swollen up like crazy but hadn’t burst, which meant the surgeon was able to get it out laparoscopically, ie, from the outside, with minimal invasion. (He told me it was “unusually challenging.”) If they’d had to fully chop me open, we’d be talking recovery of weeks and months, not days.
I had my kidney taken out laparoscopically a couple of years ago and I recovered from that within a couple of days, so I was optimistic. One of the first doctors I talked to said it was possible I could get out by Sunday. That’s when my train to Copenhagen was scheduled. I could still pull off the vacation!
Two things happened on Saturday. One, tests revealed that my blood CRP (C-reactive protein) level, which is a proxy measure of inflammation and infection, was not yet at a safe point, nor was it falling. So maybe they would release me on Monday? Maybe.
Second, I got a roommate, who Mrs. Volts and I took to referring to as Oscar. Whatever Oscar had gone through made my experience look like a picnic. He had tubes and bags hanging off everywhere. There was no curtain or divider, so I would become intimately familiar with the rhythm and odor of Oscar’s various bags being changed. Intimately.
Sunday was a low point — honestly one of the lowest points of my life. I woke up feeling awful. The day’s blood test revealed that my CRP level not only wasn’t falling, it was spiking. For reference: they don’t want to release you until your CRP level is under 100; on Saturday, it had been about 180; on Sunday, it hit 285.
They did a CT scan, looking for a pocket of fluid, an abscess, that might explain it. If they had found one, at least a clear one, they probably would have had to open me up, exposing me to all the risks I’d avoided by going laparoscopic. They found a few suspicious dark spots here and there, but decided just to change up the antibiotics and keep going with that.
Also on Sunday: Mrs. Volts was struck with a terrible flu-like something that she was convinced was Covid. Woo! Now we were really having fun.
The only thing I really remember about Monday is a conversation with my (medically trained) brother, who’d been following all this from afar. Unbelievably, I was still whining about whether I’d get some vacation time, or whether I’d have to cancel more work stuff. He said, “You need to forget about all that and focus on surviving this,” which was … bracing. People die from post-operative infections all the time. I’m not special. No reason it couldn’t be me.
So, that was the first half of my Germany trip: the rapid, violent telescoping of my perspective from “I can’t wait for Copenhagen” to “I hope I don’t have to cancel Copenhagen work stuff” to “I hope I still get to see Copenhagen at all” to “I hope I survive this so I can see my children again.”
As for the second half, I’ll spare you the play-by-play. I lay there like a zombie while my body fought the infection. Poor Mrs. Volts laid in her hotel room, mercifully negative for Covid but too sick to do anything (and, as you might imagine, stressed all to hell). In the afternoons, at 4:00, we’d meet outside the hospital, hobble our weak asses around the adjoining park once, and then head back to our respective beds.
By Tuesday, my CRP level was moving in the right direction; by Wednesday, it was down to 180; by Thursday, down to 84. Out of the woods. Discharged.
We’d (re-)scheduled a flight home for Saturday, so in the end, Mrs. Volts and I did actually get 1.5 days of vacation, which we largely spent in the hotel room watching prodigious amounts of TV. We flew home, mercifully without incident, and now here we are: in our house, with our kids and pups, safe and sound, something that had begun to seem like an impossible dream.
This account is already self-indulgently long, so let me just wrap up with a few brief reflections on this whole mess:
Overall, I have no tidy moral of the story, no lesson or wisdom to share, because all of this just felt so completely random. Uh … watch out for your appendix? Don’t be afraid to buy travel insurance? Try not to schedule your medical emergencies at the onset of your international vacations? As one of the German doctors said as he was ultrasounding my abdomen yet again, “sh*t happens.”
I’m not a religious believer of any sort, but I spent a considerable amount of time in that hospital bed thanking the universe that Mrs. Volts was by my side when all this went down. There is no one better in a foxhole. I shudder to contemplate how it would have unfolded if I’d been alone. I mean, I think about it a lot. I work myself up into a retrospective panic about it. Thank you, universe, for Mrs. Volts. Thank you.
Every human being I interacted with in the German medical system was solid, efficient, and competent. I have a few quibbles — somehow the hospital food was even worse than all the clichés about hospital food — but in the end, they saved my life and healed me up and there was approximately zero paperwork. I will never forget going to the nurse’s station on the day of discharge, girding myself for all the exit forms I’d be filling out. They just snipped my bracelet off and waved goodbye.
Our insurance doesn’t cover us when we’re overseas, so we ended up paying out of pocket for all of it. That thought scared me at first, but all told, our bill was, conservatively, about 1/30th what we would have paid out of pocket in the US. In fact it was considerably lower than what we would have paid in copays in the US even with insurance. Hilariously, the most difficult part of paying was actually paying — they’re not really set up to take money! The payments department was one beleaguered lady with a hand-held credit card reader.
What I’m saying is, the US healthcare system is a monstrosity that piles endless, needless financial and bureaucratic hassles on top of what are already traumatic experiences.
After a few days in a hospital room, it becomes difficult to imagine anything beyond its four walls, as though all the rest of life had been some kind of half-remembered dream, but the second I left — the very second — the room became difficult to call to mind, as though it had never happened at all. The brain adapts so quickly, even when you don’t really want it to. It’s wild.
Hamburg is, despite everything, gorgeous, gorgeous, gorgeous. Completely underrated European city.
I still desperately want to go to Copenhagen! They’re opening up a bunch of new direct flights from Seattle soon. I’m going to make it happen, even if it kills me, which apparently it may.
Anyway, that’s that. Worst vacation ever.
This is why I’m behind on emails and behind on pods and generally a bit of a mess. I hope you’ll be patient as I get back up to speed. I am thankful, as always, to the subscribers who make all of this possible for me.
Yikes, what a trip! Glad you're ok. As a physician early in my career, it is depressing how bad our system is in the US, and just hope that reform comes before I retire. Please take any time needed to recover, it sounds like the kind of trip that you need a vacation from afterward!
You're going to hear this from a lot of other commenters, but you have no idea what kind of terrible, horrible, no-good, very bad experience you were spared because your appendix didn't actually explode. Twenty years ago, when I was in college, the exact same progression of symptoms befell me. Except, assuming myself hale and hearty and impervious to any threat to my life, I waited. Surely it was "food poisoning!" (Why do we always think this?)
By the time I finally got myself to the hospital and made it through *12 HOURS* of increasingly excruciating and desperate ER wait-room waiting, my appendix had well and truly burst its membranes. At this point it was clear to the attending doctors that I probably wasn't making up my symptoms or seeking pain meds and they rushed to to the OR. The fact that my appendix had sprayed infection all over my vulnerable insides somehow went undetected by the surgeon, who went about slicing me the laparoscopic way as if nothing had happened. After a few days, my profit-optimizing medical team rushed me out the door of the hospital without as much as a promised CAT scan. My doctor even berated me on the way out for having quite a bad attitude and not leaning into my recovery! "You must BELIEVE in health, Geoffrey!"
Several weeks later, I was on my second hospital stay, down to a skeletal half my body weight, literal hours from death by the post-op infection that the first team hadn't bothered to check on, on my second round of significantly more invasive surgery (I believe it would be more accurate to say I was gutted like a fish), forced to drop out of college on medical leave, and VERY bitter about my mistreatment at the hands of the American medical system. I had about eight months to ruminate on it, as I very slowly learned to eat solid food, breathe with more than 10% lung capacity, and haltingly walk again.
But I'm lucky because I'm alive. I learned afterward that my prognosis was about a 5% chance of survival. I was also lucky that I was still on my parents' insurance, since the bill they sent to the insurer was $85,000. Where I wasn't so lucky is how two-thirds of a year spent trying to not die delayed my graduation enough to land the start of my working life in the middle of the Great Recession. So my in-pocket post-graduate job prospects were gone and years of underemployment awaited, instead. I aged out of my parents' health insurance eventually, and thankfully nothing else too terrible happened to me while I was uninsured. But this emergency and its aftermath did set me on a very different path.
A path that, as fate would have it, brought me now to live in Scandinavia. Here, I have been party to many other medical emergencies within my family, but none of them addressed with such wanton callousness and neglect as I saw in an extremely expensive private American hospital. I often ask apologists for the American medical system whether they, themselves, have actually had a good experience the last time they visited the hospital or had to tangle with their insurer to pay for it. Because it's always awful. An additional, exhausting indignity on top of your already traumatic struggle to claw back to health. Surely we could do better? I mean, I know we could. Everyone else in the developed world somehow does. So why do we put up with it, is the better question!