“Tür zu! Es zieht!” – A sentence you might hear quite often when entering German houses. And no, this is not a special greeting, and there is no friendly answer to it. Just close the door. Someone just complained that there is a draught, and nothing is more worrisome to many Germans than some air movement. It can cause everything from deadly man flu to severe neck- or back pain: “Ich hab Zug bekommen” – I caught some draught.
Draught is one of many typical German worries that sometimes cause confusion for non-natives and can lead to serious conflicts on car rides, in trains or buses (not to speak of the question whether or not the bedroom window has to be closed at night). Cold feet are another one of these threats: German mothers seem to be in total agreement that not wearing socks will lead to bladder or kidney disease, if not worse, even a common cold!
There was a time right after my move to England when one of my friends in Germany suffered a Hörsturz – a specific, stress-related failure of hearing and vertigo, sometimes painful, always followed by tinnitus, and a common cause of sick notes. The word “Hearing plunge” sounds as dramatic as the condition is for those suffering from it, yet nobody in England seemed to have ever heard of it, and there simply was no word in any dictionary describing it properly. “Sudden Hearing Loss” doesn’t cover it, because a Hörsturz is an acute, painful, distressing illness that puts people out of work for long times.
A similar term is the famous “Kreislaufzusammenbruch”, literally a “cardiac failure”, which sounds horrible but should not be mixed up with the very serious cardiac arrest. English doctors call it “circulatory collapse” and don’t seem to come across it very often – and if so, it is usually combined with another issue. Dehydration, heat or exhaustion can lead to the typical symptoms of a circulatory collapse, but most of the time it’s part of a panic attack and is treated as such: a mental health problem.
Looking back it seems a bit weird by how many cases of Hörsturz and Kreislaufzusammenbruch I was surrounded in Germany. The reason for that is surely not that my fellow countrymen are particularly squeamish. It’s rather a case of sound and thorough healthcare. Health issues are not to be ignored, they are to be addressed heads on and with some effort. To ignore a cold means “eine Grippe zuverschleppen” (to drag out a flu), and that is in itself dangerous.
Health care, insurance and prevention
Health care in Germany tends to be thorough and very focused on prevention. Once in a year, on average, you would see a skin doctor to search all of your body for moles that might be cancerous. Specialized tools are being used, and everything that’s suspicious is being probed right away. From 40 years of age men will see an urologist once a year to have a proper prostate check up. Women see their gynaecologist in regular intervals, same goes for the dentist (just like in England, though), and specialized kids doctors see their patients for checkups all the time as well.
There is no NHS. Healthcare is a weird mix of private and public agencies and institutions, every adult is required by law to take out health insurance – the state insurance is organized in small specialized insurance companies that together form the “gesetzliche Krankenkasse” (the lawful health insurance). This system is semi-public and partly financed by tax money. Employed grown-ups pay half of their insurance themselves, the other half is covered by their employer, the amount of payment is a percentage of the income. Children are insured for free with their closest relative, usually their parents.
If you are self-employed, using these insurance offers is voluntary. You can also choose to go for one of the big private insurance companies that work pretty much like those in the US: Competitive, restrictive and pre-existing conditions or old age will make them pricy or unavailable. Relatives have to be insured separately. Employed adults can also opt for these private insurances if their income is higher than a certain threshold.
If this sounds complicated, wait for the choice of doctors and treatments. Every German is supposed to have a “Hausarzt” (a House Doctor, a GP), but they are also free to go straight to specialized medical professionals without seeing the doctor first. Most services – from x-ray to MRI – are available in private surgeries, reducing hospital visits to actual emergency cases or severe illnesses. An army of “mobile nurse services” sends qualified nurses to private homes to take over care that would happen in a hospital in England.
Doctors, by the way, always wear white. “Halbgott in weiß” (demigod dressed in white) is a common term for medical professionals and at the heart of various corny novels, movies and TV series. If you want to get deep insight into the German mindset, check out “Schwarzwaldklinik”. It is amazing to watch pretty, but prissy doctors in a middle-classy South German town working their way through the German version of “Chicago Hope”. The differences couldn’t be more stunning.
Trailer from the “Schwarzwaldklinik” (Black Forest Clinic)
When it comes to real illnesses, Germany isn’t much different from England, although alcohol-related ailments seem to be less common (to my surprise). Cancer, heart attacks and back ache lead the rankings, followed by strokes and depression. The average life expectancy is not much higher than in Britain: 83 years for women, 79 years for men, both exactly one year more than for the average person in the UK. Interesting is another number: Brits can expect to spend 16 years of their life in “not good health”, mostly at the end of their life span.
No article about German illnesses would be complete without this little gem: Lower back ache of the lumbago type is called “Hexenschuss” in German – a shot by a witch. So you definitely know whom to blame for your pain. May you never be the target of it!