In this Update:
- Getting the Simulation Lab Functional
- Enjoying More Outings
- Disaster Strikes Again
Getting the Simulation Lab Functional
As I mentioned in my previous update, the Simulation Lab I inherited was a… what can I say, hot mess! And since there was nobody to orient me, I just started with doing inventory to see what I was working with. It was mayhem! All my (very heavy) manikins were sitting on tables, my second CentraLine task trainer was AWOL, and the new group of internal medicine residents were about to start their rotation, needing the services of the Simulation Lab, in a couple weeks… No pressure here! Thank goodness for my strong connections to the adjacent National SimLEARN Center, where I borrowed two amazing Sim Techs to help me update and troubleshoot my equipment!
Otto 
Fred
Even though things were a mess, it also gave me the opportunity to make this lab my own. I figured out things on the fly, identified my allies, found necessary resources, developed a grant proposal to replace much needed items, networked with a lot of departments and specialties to increase training opportunities and add to the curriculum, hunted down data to back-track utilization, and implemented a new tracking tool. Then I created post-simulation evaluation forms, sign-in sheets, and helped develop high-fidelity case studies. I am also working on the application to re-certify the Simulation Lab, which is due in October…
I can’t say I have been bored. My direct supervisor told me at one point that I accomplished more in three weeks than others in six months… Well, this came in handy when disaster struck later that month…
Enjoying More Outings
Since I now have a consistent schedule, where I am home in the afternoon, and with all weekends off, doing things on my days off has become much easier. Ralf and I have continued to have some outdoor adventures, despite the daily rain and steaming heat.
Disaster strikes Again
As it turns out, this awful year of 2020 is not done yet, as the next disaster occurred. On July 8th, my mom called me in the evening to let me know that Karl-Heinz was in the hospital. When she was looking for him to eat dinner, she found him undressed, on the floor, with altered mental status. She was trying to get him up but when that didn’t work, she called the neighbor for help, who in turn called the ambulance. It was so heart-breaking when she described to me on the phone what his symptoms were… I looked at Ralf and said “he had a stroke”. My mom didn’t even know which hospital they brought him to, so I googled the area and called to most-likely place. Even though they wouldn’t give me any information over the phone, it was confirmed that Karl-Heinz was in intensive care at their hospital. I gave the nurse I talked to my mom’s phone number, and a doctor called her within the hour.
What really upsets me about the German healthcare system is that it appears to be stuck in the 1960s. Nurses have no autonomy and limited scope of practice, and doctors are the “gods in white”. Family is not really included in the care, so nobody will give you information or explain things that can be understood by non-medical people. In fact, it wasn’t until the next day when I finally was authorized and able to talk to one of the doctors that I realized how bad Karl-Heinz’s condition was. And of course, I had to explain it to my mom, who still didn’t quite understand the magnitude of the circumstances. I made her cry, and it broke my heart. So, Karl-Heinz suffered a massive stroke, caused by a third-degree heart block that resulted in three blood clots that then traveled to the brain, bringing on the stroke. He had been unconscious for the first week, so when I arrived the following Monday, he didn’t even open his eyes.
I felt really bad when I had to let my new boss know that I had to go to Germany in a couple days. Even though I only started in the Education department three weeks ago, she was so accommodating, getting my FMLA filled out and approved within one day! I was even cleared to take my government laptop to telework, since I didn’t have much leave left. On Sunday July 12th, I was sitting in the Orlando Airport, mortified of flying international during this deadly pandemic, and worrying about possible quarantine when I got there.
And don’t think that United Airlines would leave the middle seat open: the flight to Frankfurt was packed! However, I booked Economy Plus on way there, so I was facing a wall ahead, and the lady next to me was a mother of a young child, so she was facing mostly the other way. There was also a sweet puppy on board, on her way to Italy.
When I arrived in Germany, I was so very anxious about what would happen next. I was standing in line at immigration, and when I handed over my Germany passport, the officer just wished me a good day!!! No questions about where I am coming from (a Corona hotspot!), so I grabbed my belongings and bee-lined to my connecting flight to Hamburg. Such a relief!
I arrived in Hamburg around 10 am, and after collecting my luggage, I was picked up by my mom and the neighbor’s son in law. It was so strange, since it was always my mom and Karl-Heinz who would great me at the airport. But not this time, not ever again… It takes about 1 ½ hours from the airport to Wesselburen, and after we arrived, I freshened up and drove to the hospital to see Karl-Heinz that afternoon.
It was bad. So bad. My mom was so lost as we were sitting at his bedside. Karl-Heinz wasn’t conscious but combative, so they had to restrain him. Staff wasn’t able to provide any hygiene care, and since the stroke caused significant dysphagia, he already had a PEG tube placed on day two. He also had a pacemaker inserted to fix the heart block. Stupid, uncontrolled hypertension! I always told him that this can have serious consequences if he doesn’t get his BP under control – but it is what it is, and even though I was angry on some level, I felt so very sorry for him.
I had less than two weeks to figure things out and put resources in place. My mom doesn’t drive and is pretty much dependent on others in that little town she never quite liked to live in. I needed to find a solution for her living situation since she can’t (neither does she want) to live in that house with that enormous yard that turns into a jungle during the summer. And Karl-Heinz – he will need a nursing home placement from what I could tell. What a giant mess!
First of all, the house was a disaster on its own. Little did I realize that Karl-Heinz was kind of a hoarder, so instead of throwing stuff away, he would throw everything in either the attached utility room or the garden shack. When my mom told me, I took a look and swallowed hard. How on earth am I going to clean this up? So, the handyman neighbor and I worked two days, emptying out the trash and sorting things out to be picked up by the waste company.
Before...
...After
Next, my mom was asking me if I could try to open the freezer. She said that she couldn’t get it open anymore, and so they left it like that for over one year!!! They just stopped using the freezer… It took me almost an hour to pry that thing open, with the aid of hot water and my old Udo Waltz hair dryer. In fact, I landed on my ass when the door finally popped open. What I found behind was solid ice. I mean, that thing had a solid wall of ice where the door used to be! So Udo Waltz and I got to work, and between the heat, a wooden spoon, and hot water interventions, I managed to defrost the freezer. It was still full of food, which had already expired for the most part….
Before 
After
We went to see Karl-Heinz every day in the hospital, and the following week he finally came around. But boy, this was awful. He was awake and alert but stuck in his own body. He can’t talk, can’t eat, is incontinent, and his right side is paralyzed. Whenever we came into the room, he would look at us, look at my mom, then his left hand came up, grabbing her hand, and so she would sit for the hour we were allowed to visit. When he finally was transferred to the neurology floor, he was well enough that his restrains could be removed. Baby-steps I suppose.
I know he was anxious, a busy body, while lying in that hospital bed. I brought him a heart: a red stress ball that I had squeezed all the way across the Atlantic Ocean. I put it in his left hand when we left, and he still held it when we came back the next day.
I was trying to figure out how my mom could get from Wesselburen to Heide without a car. It’s about 18 km, so taking a taxi was getting way to expensive with about 60 Euros/day. My mom is very insecure when exiting the train due to the giant gap between the train car and the platform, so even though this option was cheaper, it didn’t work. So, I found the number of a group of neighborhood volunteers, who help other with errands for a nominal fee. Luckily, there was one driver who agreed to drive her EVERY DAY to Heide, wait there for an hour, and take her back. What a relief!
Another stab in the heart came in the mail: Karl-Heinz got a ticket for driving over the speed limit, and in Germany, they always have a picture they mail you as proof. Here he was, behind the wheel, just a few weeks ago. Now I have to figure out how to sell his car because he won’t be driving it ever again…
In the meantime, I was still trying to get rid of empty bottles that I found in the shed and shack. In Germany, plastic and glass bottles need to be returned for a refund. I had bags, upon bags, upon bags I had to return – it ended up to be a total of almost 100 Euros in refund! Some bottles were so old, their content expired in 2013…
At that point, I overcame my fear of driving a shift stick in Germany, something I hadn’t done in 20 years!!! But after I got over myself, I was very happy that we were somewhat independent again.
Then the biggest miracle happened: as I was calling nursing homes around the area, I ended up calling the Red Cross institution in Büsum, which is a cute tourist town right at the North Sea. My mom said, “don’t even bother, they won’t have anything open”, but I was desperate. I talked to that wonderful lady, explaining what had happened and what I was looking for: an assisted living apartment for my mom, and a nursing home placement for Karl-Heinz. The lady was a little hesitant but then said that they actually had an apartment becoming vacant, and there may be a place opening up in the nursing home as well!!! This was like winning the lottery, and I know that we were given an (unofficial) break – and I will be forever grateful! The next day, we had an appointment to look at the place and it is perfect! My mom loved the apartment AND she is allowed to bring the dog! Plus, I don’t have to worry too much because it’s assisted living, so my mom will have resources when she needs them. In addition, she can just walk over to the nursing home section, pick up Karl-Heinz in a wheelchair, and bring him on outings or to her place. Under one roof after all, so I consider that the best possible scenario based on the circumstances…
My last task at hand before I had to fly back home was trying to file a petition with the courts get control over Karl-Heinz’s financial assets. Because of my black-sheep brother, my mom didn’t want anything in her name. I was put as the sole heir of Karl-Heinz if he was to pass away. Apparently, nobody saw this scenario coming, and since there is no legal regulation in place, I have to now try and get a judge to give me the ability to sell the house and the cars. But that I will have to deal with after I return home for now…
Flying back home was hard. Leaving my mom behind with the situation made me feel like I am deserting her – despite the resources I managed to put in place. When she cried at the airport, it just tore me apart, but I had to get back home to Ralf and my (new) job as well. The airport in Hamburg was actually very safe: people in line for security were social distancing, everyone was wearing a mask and followed the rules. But as soon as I stepped of the plane in Orlando, all bets were off!!! Tourists with their kids everywhere, masks were worn or not, and many just jaywalked as they pleased. What a difference to Europe, where I actually felt relatively safe…