Day trip to Bodensee

October 3rd, is a national holiday in Germany, in view of German Unity Day. It is recognized as the day when the formal reunification process was initiated. I was always under the impression that the Berlin wall was brought down on this day, but, I was surprised to know, that actually happened on the 9th of November, 1990. Seems 9/11 wasn't a suitable day to celebrate, as, it was also an anniversary of a Nazi pro gam on Jews.

Any holiday in Germany means, half the population is driving on the autobahn for a vacation!. And this holiday, we were not to be left behind!. It was our only prospective sunny day in the week!.

We made a short, frugal day trip to Bodensee, situated about 2 hours from our place. Traffic on the autobahn, always frustrates my husband!- surprising for someone who has driven for more than half his life on the chaotic roadways of India!. My toddler son was no less irritated, having being strapped in his car seat for a greater part of the journey.

We finally made it to Bodensee, at noon. Our destination was Unter-Uhldingen, a quite village on the lake shore, that boasts of a Bronze-Age habitat museum.

But first, our priority on reaching there was feeding our famished stomachs!. There were a number of "ristorante(s)" and "gaustehaus'"along our walk to the lake shores. I love the way, the menu for the day is scribbled on a chalk-board at the entrance of the restaurants- you can go in only if you want the food and have the money!. Fish seems to be the entree of choice for all the places. However, we stuck to pizzas and ice-cream at a surprisingly deserted Italian cafe. The "Apfel schorle" (apple juice) was the pick of our meal- it was delicious!.

Stomachs full, we perched on the pebbled banks of the lake and immersed the view. Splendid sight!. The sun was just right. The waters were sparkling blue. Ducks waddled in the waters, occasionally diving whole into the waters and then resurfacing again. Sea-gulls flew overhead. The Swiss shores were diametrically opposite to where we sat, but were clouded in mist. Yachts drifted lazily on the waters. An occasional speed-boat or cruise ship completed the events on the lake. Simple and laid-back.

My toddler son was engaged in a play ground near the banks. After a while, we went for a walk around the lake.

We wrapped our trip, with a visit to a Tractor museum, nearby. I love the way they have museums for everything here!. The tractor museum was a great place to get some in-sight into centuries old farming practices in Europe. It had some wonderful collection of tractors, from John Deeres' to Maser Fergusons'. Also, picked up some super tasty Bodensee apples for 1kg=1euro at an unattended house sale near the museum!. Love the trust in people these country folk have!.

Petting Zoo- Nymphaea

Mid September, we made a short weekend outing to a small petting zoo near home, called Tier park Nymphaea, situated on the banks of the river Neckar. This quaint floral and faunal paradise is commonly called the "other zoo" by Stuttgarters (the main zoo being the Wilhelma Zoo on the north of the city.

Nymphaea is a conservation park, that lets you get real close to a few animals and birds. It is so wonderfully built, without disturbing the natural eco-system of the riverbed. It is run by a club of motivated conservationists who are ably helped by a team of school student volunteers.

My little one, now nearly two and a half, has been to 2 zoos thus far, and has never been too interested in knowing and feeling animals. I embarked on this idea of visiting a petting zoo, to try to get him interested in nature trails. So did my idea work?.. not entirely.. but somewhat!

The park fees is nominal for adults and free for young kids. Once inside, you get to see hens, roosters, turtles, wombats, rabbits, owls, bees, ducks, swans, parrots, peacocks, pigs, donkeys, goats, mice, snakes, otters and deers. Feeding the animals is the best part!. You can buy a mug of popcorn at the cash counter and feed the animals as you go! (feeding the birds is not allowed!).

For me, the highlight of the visit was feeding a deer and feeling an otter. For my son, it was probably seeing a bed of slithering snakes!. Funny, I thought he would be scared of seeing that, but no!, he was clearly impressed!.

A few lessons from a short observer stint at a German hospital

In the first few weeks of September, I had the opportunity to visit a well-known hospital in Stuttgart, to spend a few hours each day, "observing" the system. Not knowing the language, was a drawback for me, impeding any medical knowledge from coming my way. However, it was a chance to learn a few basic things about the "system" and how it works here. Here are some of the things I would love to implement back home.

Keep bedside discussions away from the bedside!

In India, bedside rounds were nearly always, a tedious affair. Doctors would crowd around the patient to discuss the progress (or sometimes the lack of it). The poor patient would lie in the midst of this mob-like discussion of the facts of his/her case, often having to listen to the dismal details of their condition. Moreover, if the resident in-charge was to be reprimanded for any of his/her errors, it would be done right there, in the full galore of all the ward patients!. I always wondered if this entire exercise was necessary or if we could do it in a better way.

Seems there is a better way. Here, the case discussions are done in the doctor's room, before the real meeting between the head doctor and the patient. The resident doctor does his/her clinical rounds before the discussion. Then, they all sit it out in the doctors room, before their electronic gadgets, going over all the patients details. All lab data is just a click away [no need for the resident to memorize (or be tempted to lie about!) nitty numbers!]. The nurse in-charge of the patient is also party to the discussion and often provides valuable inputs on symptoms and complaints. It is a relaxed and mature discussion. It is more fruitful for the patient as his/her case is better discussed and analyzed.

Access technology/ resources when making clinical decisions

Having the discussion in the doctors room, also has the advantage of being able to access valuable information related to individual clinical decisions, at the click of a button or at the hand's stretch (at the book library). Doctors can't keep everything in their head. Using technology effectively and in timely manner is important.

Keep bedside visits pleasant and comforting

Having taken care of the clinical details of the case, the bedside visit is now focussed on exchanging pleasantries with the patient. The patient is more comfortable with the talk directed to him/her rather than between the doctors in-charge. I have often felt, that we don't do this enough in India.

Talk to the nurses

After the discussion and bedside rounds are done with, the resident's task is to call on the nurses and instruct them in a clear format what is to be done for their patients on that day. Everything is written and undersigned by the doctor and the in-charge nurse!. Here, the nurse's role is supreme- in fact she is the primary care-giver here who co-ordinates all the orders.

In India, nurses are given a raw deal. We never really acknowledge them as equals. Of course, in many cases, nurses are not really inclined to work!. But this mature interaction between the doctor and nurse, is something that needs to be emulated.

Patient information sheets for every intervention

Before any intervention, the doctor and nurse, arm the patient with a superbly descriptive patient information sheet, written in a language the patient and family can understand. This is given to the patient well before the time of the procedure. The patients are required to sign the form, as having consented to the procedure, having understood the risks.

Back home. we vaguely describe the procedure (orally!) and take a hasty consent (if at all!). This needs to change.

Acknowledge the primary treating physician

In the discharge sheet of every patient, the primary referring physician is sincerely acknowledged.  A detailed story of the patient's stay at the hospital is written down for their reference.

Very rarely, do we in India, even turn the pages of the case file to see who has referred this patient to us!. Networking is everything.

Have a summary sheet out front which reads like a biography

It only takes 5 minutes to get acquainted with any new case in the wards here. Everything in the patient's medical history is neatly typed out on a summary sheet placed on the front of the file, which is complete with dates and events.

Ward design and care

Cleanliness is one thing; but, having a beautifully designed ward is another thing altogether!. Its amazing how comforting, for any visitor/patient, a brightly lit ward with colorful pieces of art and windows streaming in sunshine, can feel like.