Vienna in the time of COVID – Chapter 3

As my wife and I near 168 consecutive hours in each other’s company, I am learning that in these troubling times, good communication is an important skill to master. 

To be fair, my wife and I have always been good communicators. Having spent the first four years of our relationship in a dual-country long-distance relationship, without good communication our status would have slipped from partners to pen-pals. During those four years, we had a standing eDate every evening after work. Our romantic location of choice was skype (occasionally mixing it up with facebook messenger or even viber when skype decided to crap itself) and we would chat every evening through our computers, doing our best to convince ourselves we were a normal couple.

But the good news is that we don’t have to pretend anymore! We share the same bed, kiss each other goodbye when we go to work (back in the days when people used to leave their homes to go to work), come home to the same apartment, and kiss each other goodnight. It is domestic, and ordinary, and we fucking love it. 

With a solid foundation of keeping up the communication chain across international borders, we still communicate regularly and deeply. I keep waiting for us to run out of things to talk about, but so far, I keep thinking of things I want to tell her.

These talks have recently been taking place as we go on our after-work, let’s-remember-what-the outside-feels-like walks. Yesterday, both due to Alex’s work and the desire to be a sterling example of social distancing, we strolled in the late evening when the streets were deserted, the night quiet, and we ambled through our neighbourhood with our conversation as rich as ever. 

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Also in these troubling times, I am learning that not communicating can also be a crucial piece of the mutual co-habitation puzzle. For instance, I have discovered that when my wife is on the last gripping chapter of her book, it is not a good time to tell her a hilariously funny joke, nor to then go into further detail explaining why the joke was so hilariously funny.

Being a bilingual couple brings its own set of challenges. Alex has more than mastered English, but I am still a novice when it comes to German, and so I have many questions when it comes to particulars with the German language. These questions usually come in the form of “But why?! That makes no sense! Why is it like this in this case, but completely different in this case?? I hate the German language!” 

When interrogating my wife on the semantics of a language she did not invent, only speaks, and therefore holds no responsibility for its inconsistencies, I have learnt that when her eyes begin to bulge and lips thin to the point of disappearing, I should promptly and politely shut my damn mouth. This non-verbal communication informs me that she has reached the edge of her explanations and further questioning will only end poorly for me. Perhaps with a fork in my baby-soft skin.

One of my goals from having constant, relentless access to my wife is to try and improve my German skills during this time of COVID. There’s a good chance I could walk back into the normal world (once it, hopefully, resumes) with a broader vocabulary. There’s an equally good chance that Alex will walk back into the normal world with a splitting headache and a sigh of total relief. If I was a betting man, I’d wager on the latter.

The Austrian government is currently doing an excellent job of communicating. There have been press conferences wherein the Prime Minister has given clear instructions with digestible explanations for the decisions that have been reached. They have maintained a strong social media presence and have been supportive and transparent about the actions they are taking. They appear to be proactive in their measures and this speaks volumes.

New forms of communication come through via this process, and some things can say a lot with very little, such as in the photo below. 

WhatsApp Image 2020-03-19 at 07.21.34

(Photo credit: Natalie Kern)

 

For me, being from international origins also increases the importance of communication. Despite being a twin, my brother and I never got our telepathy up and running and so we are forced to rely upon more conventional methods. Thankfully, we live in an age where technology has just about reached the level of the supernatural, so it is an easy thing for my face to appear in the homes of my family and their faces to appear in mine.

The variety of apps that allow for communication are invaluable in this time of social distancing. We can remain safe and social simply with the click of a button. I encourage everyone to lean into these forms of communicating.

Yesterday, my sister-in-law sent out a welfare text to every member of my immediate family, checking in and seeing if anyone was low on supplies (my wife did mention we had run out of a certain Australian treat I enjoy, but apparently Austria is outside of Holly’s delivery route). I had a morning chat with my brother through his google Home while he prepared dinner, I messaged simultaneous with my parents and my cousin and his fiancée throughout my work day (please don’t tell my boss I did this, I don’t think she reads this blog), I have an early morning skype planned with my sister for tomorrow, and will be on the phone with a friend back in Australia come Saturday (Jess, you’re back in the blog!).

Even from our tiny apartment in Vienna, I am able to communicate with the whole world, and by doing so, defeat the distance in social distancing. I recommend you do the same.

Now I’m off to ask my wife about the correct German case to use when referencing someone in the informal collective sense. Wish me luck!

Tomorrow: Media.

Vienna in the time of COVID – Chapter 2

We are three days deep into the working week and I am happy to report that morale in this Vienna office remains good. There has been no passive-aggression between myself and my new co-worker, nor for that matter any non-passive aggression (my wife has on more than one occasion when discussing someone who has rubbed her the wrong way stated that she would like to “stab them with a fork”, so this is no idle concern. Why this particular piece of cutlery, I don’t know. I’m too afraid to ask). Perhaps the secret to our co-habitational bliss is the deep river of communication and understanding that my wife and I share. Perhaps it is my retreating to the balcony when eating my lunch today to avoid irritating her with the sounds of my mechanical digestion. We may never know.

I do believe that during this period of government-enforced agoraphobia, one of the devices that should be used to avoid being stabbed by your spouse with a piece of cutlery is the enjoyment of extra-curricular activities. When your office, your living room, your dining area, and your kitchen are all the same 6 metre x 4 metre space, it’s important to introduce some variety to keep the magic alive.

As mentioned in yesterday’s chapter, Alex and I now begin each day with a yoga session. The assortment of aches and pains in my muscles and joints lets me know this is working well and, by the time we are freed to resume normal life, I am confident that I will have the flexibility of a prima ballerina. For now, I would be satisfied with being able to tap the ground with my fingertips during stretches where the instructor is effortlessly resting her entire palm on the mat, but we must walk before we can run.

Alex has taken on a collection of rather useful hobbies. One is that each evening she prepares our breakfast for the next morning, two bowls of overnight oats, which, as the name suggests, are oats that are prepared one night in advance. But these are not your grandma’s oats, no, hers are an assortment of flavours that ensure the day is started with a grinning face and a full belly (I don’t know your grandma, maybe these are her oats, who am I to comment of the quality of your grandmother’s breakfast preparation).

Alex starts with some dried oats and then adds puffed spelt, chia seeds, a handful of fresh and frozen fruit, natural vanilla yogurt, and a dash of milk. After being given the necessary twelve hours to reach its full potential, this combination equals a bowl that is not only tasty, but healthy and aiding in digestion. And, going by the sounds heard through the shared wall of our office and toilet, I’d say it’s working.

I have taken a different approach to my free-time activities and, much like children all over Austria penned indoors, I went straight for the pencils and paper. Drawing is a discipline that feels akin to meditation. Through focus, I am able to empty my head and let go of whatever unwanted thoughts are plaguing my brain. The repetition of the pencil strokes occupies the stimulant-driven portion of my consciousness while the rest is free to sit back and take a load off. 

(click to see a larger version)

This activity also provides my wife with, much like parents all over Austria penned indoors with their children when they dig into the art supplies, a moment of peace and quiet to read a book.

Books are vital when living in the time of COVID. Of course, I would argue that books are always vital, but they become doubly so when used as compensation for social interaction. And I don’t want to brag, but I’ve been using books to replace social interaction since I was a teenager. 

Mostly I do my reading while simultaneously drawing. No, sadly, I am not some ambidextrous prodigy, rather I use the medium of audiobooks to get the narrative into my head. I could go on at length about the merits of audiobooks, like a rabid missionary desperate to snag his next convert, but I will try and restrain myself and say only that the act of listening to an audiobook has the ability to transform any domestic task, be it the washing up, vacuuming the house, or going for a run, into an experience wherein your mind enjoys the exploration of characters and story while your hands slave away at the dirty work.

My brother and I love audiobooks to the extent that we have created a club around this topic, and have even gone one step further in that Damian also created an emblem for our club, as pictured below.

Audiobook Club 2

Granted, our club presently only has two members, but that doesn’t get in the way of our overwhelming pride in it.

So far, this combination of routine and hobbies has kept Alex and I on the right side of sane during the COVID purgatory, and has ensured that my baby-soft skin remains fork free.

Tomorrow: Communication.

THE BAD ONES #03

The patient was an eighty-eight year old man who lived at home with his wife, both of whom were surrounded by a perpetual cloud of smoke despite our nurse’s continued requests that they butt it while we visit. He was a man just managing to stay at home by the skin of his teeth – or, more accurately, by a lot of effort from the support services put in place to keep him safe at home, services neither he nor his wife appreciated. They both had a diagnosis of dementia and shared a common lack of insight into their own failing health and poor living circumstances. Neither acknowledged the nicotine-stained walls or ceilings, the carpeting stained with old and fresh dog shit, or their own deteriorating bodies and minds stained with years of neglect and abuse. In their estimate, they were, ‘…doing fine, and we don’t need anyone barging in and taking over!’

But despite his shortcomings, this wasn’t enough to make him one of the bad ones. Once you got past the bluster and opened a window to air out the house, both he and his wife were pleasant in their own confused and belligerent way. The problem was the patient’s GP.

The patient had returned home from a short stay in hospital due to his yo-yoing health, and, as hospitals are prone to do in an effort to prove they did something to help the patient, they had played around with his medications. This slight tweak on their behalf often means a mountainous headache of work for us. Easily one of the most infuriating and frustrating aspects of my job is attempting to get a list of my patient’s medications, complete with the drug’s dose, route, and frequency, and topped off with a signature from the prescribing doctor, so that I may legally administer those medications.

Perhaps you’re reading this, thinking, “Surely, that’s not so hard a thing to obtain. A doctor would have on file the current medications his patient’s are taking.” This world of doctors keeping an up-to-date list of their patient’s medications is one that belongs in a medical utopia, a place where patients are keen to participate in their health and old stoma bags smell like vanilla essence. Unfortunately, I operate outside that sphere, and consider it lucky if the GP I’m corresponding with has a computer on which to type a list of medications. The stereotype of illegible doctor’s handwriting is very real.

The client’s GP was a doctor I was familiar with, and I knew him to be a man resentful of assisting in any way. His choking arrogance always seemed to get in the way. So, knowing this, I rang his office.

‘Hi, this is Jonathan the district nurse, I was just hoping to speak to the doctor regarding Mr X.’

‘Oh, sure,’ his secretary replied, ‘I’ll pop you through.’

*On-hold music* – wait time 30 seconds.

‘Yes.’

‘Hi, Doctor, this is Jonathan the district nurse. I’m just ringing because Mr X has returned home from hospital. He was diagnosed with GORD while in there and commenced on Nexium, and I was hoping you could add this to his medication authority and fax it through to us.’

*Click*

He had hung up.

I rang again.

‘Hello, Doctor’s office.’

‘Hi, this is Jonathan again. The Doctor just hung up on me. Could you put me through to him.’

‘Oh. Sure.’

*On-hold music* – wait time 1 minute.

‘Yes.’

‘Doctor, it’s Jonathan again. We got disconnected. So as I was saying, we just need a new medical authority so we can administer Mr X his new medication.’

‘What is all this?’ he grunted. ‘I’m sick of doing all this work for your company. Why don’t you have your own doctor on staff?’

‘You know how we operate, Doctor, how community health operates. You’ve worked with us for years. You know we don’t have our own doctor on staff.’

‘I’m sick of doing all this over the counter work, it’s ridiculous.’

‘Sorry, I’m not following you. What do you mean “over the counter?”’

‘Well, it’s not face-to-face, is it? I’m not billing for this.’

‘Oh, so you’re worried about your money?’ I chuckled.

In retrospect, laughing may have been the wrong tact to take.

*Click*

I squeezed my mobile phone, envisioning the pathetic old doctor’s neck, and rang a third time.

‘Hello,’ his secretary said.

‘Yeah, it’s Jonathan again.’

‘ I thought so, it’s why I didn’t answer with the spiel. Is it a connection issues or is he angry?’

‘Oh, he’s angry. Can you put me through again?’

‘I can try.’

*On-hold music* – wait time 3 minutes.

‘Are you still there?’

‘I’m still here,’ I replied.

‘The Doctor’s busy at the moment—’

‘Uh-huh.’

‘—but tell me what you need and I’ll see what I can do.’

I detailed what was required, explaining that my persistence was only to ensure the patient got his medications and remained out of hospital. I did my best to stay calm and jovial with the secretary, reminding myself that her employer’s childishness was no fault of hers, that she was the only one attempting to help, and that she had to put up with the megalomaniacal wanker for hours at a time. Once I had repeated what I needed and she wrote it down, she assured me that she would have it faxed to me by the end of the day. I thanked her, sincerely, and hung up.

It’s hard to work in an industry full of contradictive people claiming to be there to care for others whilst only caring about themselves. It’s hard to advocate for your patient against the very people who should be helping. It’s hard to remain professional while those you deal with act like children. And it’s too easy to think, ‘Why do I continue to work in this faulted system?’

The secretary was true to her word, and by the end of the day I had a medical authority with the patient’s new drug added to the list. Unfortunately, the previous authority had two medications that, due to the Doctor’s past laziness, had only been scrawled on by hand, and hadn’t come across with the new list. I would have to phone him the next day to have them added.

He was one of the bad ones.

THE FIRST TIME

One of the most common things my patients say to me, excluding those unfortunate few who have lived with a chronic condition most of their lives, is “This is the first time I’ve ever been sick.” They say it as if daring me to believe it, because they themselves are having a hard time believing it. Their run of perfect health has inexplicably come to an end. They quote at me their perfect medical history, taking pride in their previous resilience:

“I broke my arm when I was seven, but beyond that I’ve never even seen a doctor!”

They are always surprised that their bodies have let them down. But why? Why are we taken by surprise by the fact that we are mortal, that our imperfect bodies, which until this point have been fighting like a Spartan to maintain homeostasis, have finally, inevitably, let us down?

The evidence is all around us. We watch a plethora of television shows set in a hospital that week-in and week-out cash in on the drama that is a healthy person falling sick. And the reason this is such a successful emotional hook is because we all know that such a thing is possible, even probable, when you consider the multitude of infinitesimal processes that can go wrong within our bodies. We swap stories about the health of our families and sigh in all the right places when hearing of another’s health decline. Yet we fail to, or refuse to, make the connection that we will all eventually have an occasion where we will be, for the first time, admitted into a hospital because something has gone wrong.

The irony is these same people who proudly boast about never having their blood-pressure checked in fifty years are the same people who have been walking around with increasingly high blood-pressure for the past forty years. One morning they pass out while attempting to move a couch, end up in emergency with a stroke, and later state to their nurse with complete surprise, “I’ve never even been sick before, and now all this happens!”

My favourite patient, and by favourite I mean in a sarcastic, eye-rolling sort of way, are the ones who blame accidents or hospitals for the chronic disease they have due to a lifetime of poor lifestyle decisions. One of the best examples I have of this was when a sixty-year old man told me the tale of how he procured type two diabetes. This is a man with a gut that preceded him by at least thirty centimetres, a man who thought a six-pack of sugar-covered doughnuts to be an appropriate between meal snack, and who hadn’t done regular exercise since playing football in high-school.

Out of the two of us, I thought I could give a more accurate rendition of how he procured type two diabetes.

The story went that one day in his fifties he had decided to try riding a bike again. He pumped the tyres of his old bicycle and headed out onto the streets, flushed with the joy of being back on the road with the wind in his thinning hair. Unfortunately a neighbouring dog found the image of an overweight middle-aged man on a bike to be greatly entertaining and decided to join him. While attempting to shake the dog off his tail with a mixture of swerving handlebars, wobbling wheels and wildly kicking feet, our man lost control of his bike, fractured his hip and ended up in hospital. Where, as is common procedure, they took a blood sample and discovered he had previously undiagnosed type two diabetes.

Or, as my patient put it, “Fracturing my hip gave me diabetes.”

Despite my tactful attempt to suggest that it was simply the series of events that resulted in the discovery of his disease, that it was more likely down to the fact that he has three sugars in his tea and has eight cups of tea a day that led to his diabetes, he remained resolute that the act of fracturing a bone in his pelvis gave him high blood sugar. In the end, after half an hour of discussion, I sighed, nodded, and said with complete sincerity that I hope he never fractures his other hip or else he could end up with high blood pressure. To which he responded that he already has high blood pressure, but that he got it from his mum.

We all, every one of us, will eventually find ourselves in a hospital ward due to something that has gone wrong with us physically. It may be our fault, it may be an accident, or it may be a genetic condition that has reared its ugly head in later life, but something will happen someday.

The best we can do is accept this, and in the mean time work towards being as healthy as possible, enjoying and appreciating our health while we have it, and exploring ways we can improve ourselves when a health condition becomes known.

And for god’s sake, try to look after your hips.

They may be the only things standing between you and diabetes.