The Sonneberg Emergency Room

From across the swimming pool where I was playing with one-year old Lexie, I heard my six-year old son Lucas scream and then sob. It was not the I’m so sad cry, or the you took my place on the slide cry, but the help me I’m in pain cry.

We were in Germany for my research and to visit grandparents and a dear Uncle. Our sons Lucas and Max (four-years old) had convinced us to travel to Sonneberg for the biannual model trainshow there. The sunlit Sonneberg indoor swimming pool with its spiral slide was an added benefit.IMG_2003
“Uh oh,” I thought. With my one-year old under my arm, I walked quickly to Lucas and saw the Sonneberg Bademeisterin – swimming pool master- had gotten there first.
She asked Lucas his name and where he was from and what he was doing in Germany; in this way she expertly distracted him at the same time she applied steristrips to the deep cut on his chin.
“You really should go to the emergency room.”
My husband Marcus and I looked at each other and with our eyes asked each other
Is it really that bad?
What will we do with Max and Lexie while we wait?
Should we just go home and see how Lucas looks tomorrow?
“Really,” the Bademeisterin told us. “You need to go to the emergency room.”
Marcus and I thought back to our experience in the US in July the previous year. At 8pm in the evening I had called the 24-hour nurses line in South Bend Indiana because of Lexie’s high fever. “Go to the emergency room,” the nurse had told us.
By the time Lexie and I arrived at Memorial Hospital, the Tylenol had kicked in and he slept on my lap. That Friday evening a series of gunshot victims came into the hospital that needed more urgent attention than my peacefully sleeping baby. Lexie and I checked in at 9pm; we saw a doctor a 5:30am.
Back in Germany, Marcus and I decided to follow the advice of the Swimming Pool Master. We got into our car, drove a few miles to the local hospital, and steeled ourselves for the long wait.
But instead, a doctor almost immediately invited Lucas into an examining room, checked the cut on his chin, pronounced that the Swimming Pool Master had done an excellent job, and told us that a doctor should have another look at Lucas’ deep cut in a few days.  Two weeks later we got the bill: 30 Euros or about $40.
Generalizing from a few experiences is unwise. Nevertheless our family’s adventure with the emergency room illustrates some differences in the US and German systems.
The financial pressures on US hospitals mean doctors are almost never as available as they were to us in Sonneberg. The large number of uninsured in the US means that expensive emergency rooms become a place where too many people receive primary care or come to the hospital after not receiving proper primary care. The robust social safety net in Germany means that health care is subsidized – the only way to explain our $40 bill. American healthcare economists might counter that having a doctor waiting around ready to see us might not be the best use of health care resources.
In any case, Lucas turned out fine – only a small scar on his chin is still visible. The rest of  us were happy that we could go home, get a good night’s rest, and start the next morning with another day of trains – for the boys – and reading and writing for me.

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