Week 40: Rent-an-Intern

For the lack of a better intro for this post, lets just get down to it, shall we?

After a few great days in Munich visiting friends and family, it was back to the hospital for a quick two days. Again, I was rotating to a different department and I had my reservations about it. Much like I did rotating into hematology/oncology thinking it wouldn’t go nearly as great as the cardiology rotation had gone, I was afraid my experience in gastroenterology wouldn’t mount to the same level of fun as hem/onc had offered.

I was also worried about how the interaction with the chief would be. During his seminars, he had a way of letting you know just how knowledgeable he was and how, in comparison, uninformed you were. Not that his seminars weren’t extremely informative, they just left you feeling a bit unworthy. My fear was going on grand rounds with him and being asked where every little factor or enzyme was produced (like one instance in a seminar of his). Due to the usual train delay in the morning, I was running a few minutes late. In Hem/Onc, the morning meeting didn’t start until 8:15AM. I had no idea where I had to be or what time the morning meeting started in Gastro. Luckily, another intern crossed my path that had been in the department before. He informed me that the meeting had already started (8:00AM) and where I had to go. Great. I was prepared for some remark on my tardiness.    

My green essentials

I arrived at the room and snuck in. Although my arrival was noticed, the meeting went on and it wasn’t until the end that the chief kindly introduced me to the staff and welcomed me to the department and offered me the opportunity to see anything I wanted to see. Gee,……why thanks!

From there, it went directly into the grand round. Uh-oh. I braced myself for a storm of complicated questions that I would only be able to answer with limited knowledge. It’s not that I doubt the amount of knowledge I have. I know there is a lot of information in my head, its just that for years on end, we were trained to answer multiple choice questions. So, if I see a question and you give me 5 answers to choose from, I’ll most likely be fine. If you ask me to answer an open end question……there are bits and pieces of information that pop up in my head but managing to put them in an acceptable spoken answer is a whole other thing. I approach questions in grand rounds openly however since that is how my practical exam will be. Might as well start practicing!

A nice surprise for me was that the questions that were asked were rather fair. Nothing totally out there. The chief also really likes to explain things. He probably even expects me to ask question just so he can explain some more. Sure, if I don’t know an answer I feel somewhat unworthy. 

Oh look, sun out there!

Often, tid-bits of information or random words will immediately come to mind when I’m asked a question. The annoying thing is that I can’t immediately explain why that might be the right answer and don’t always say the first thing that comes to mind. Even more annoying is that often, the first thing that pops into my mind is the right answer! I’m just not compulsive and think ahead knowing that the person asking the question doesn’t just want an answer but also the explanation. „I don’t know why its the right answer, it just is.“ doesn’t seem like an acceptable explanation. If you give me time to think it through, I can usually tell you why it is the way it is. But the chief ain’t got time for that! ;) Luckily there are still enough things I can explain just beautifully to make up for the answers I can’t.

The residents in the department are all super nice. They might be the internal medicine department were the comfort level of communication was almost instantaneously were as in other internal medicine departments it took a few days for them to really warm up to me.

I spent the rest of Thursday helping a resident with her patients, drawing blood from the patients that the nurses weren’t successful in drawing blood from, placing lines, etc.

I stopped by the thoracic surgery chief’s office because I was told he had been looking for me the last few days. Of all the chiefs in the hospital, he and I are totally on buddy level. He is the one who tried to convince me to stay in Germany by offering me a husband and house and a job! He informed me that the department was still suffering from a lack of doctors due to injury and vacations and asked if I would be willing to come work a week for him in two weeks. I’d basically play the role of a resident. Take care of the patients, do rounds, write release letters, be first assistant in operations……basically do that which a full blown doctor does…..just without the full accountability. I told him he’d have to talk to my current chief. He called him up right away, offered him a cup of coffee and asked him he could borrow me for a week. My chief said he’d have to ask me if that would be okay with me. His reaction nicely surprised me once again (maybe I need to change my perception of the chief). It wasn’t unheard of that chiefs would absolutely NOT give up their intern to another department. Rather, it was an exception that the chief would allow it.

After the morning meeting on Friday, chief stopped to ask me if I’d be willing to go work in thoracic surgery in two weeks for a week. He said that he wasn’t going to place stones in my way if I wanted to do it but that it was my internship year and I should be able to decide. If I wanted to learn internal medicine, I should be able to. Haha, the backhanded guilt trip. I told him that I was rather interested in learning as much as possible in internal medicine but that I understand that the thoracic surgery department is in a situation of need and that I should be so kind and help them out.

After I had my work on the ward completed Thursday and before the afternoon seminar, I found myself back in the thoracic surgery chief’s office with their current intern (pseudo-resident) and the chief of Pneumology. We talked about how theoretically fun it would be if the other intern started to work for the pneumology department and I for the thoracic surgery department. The men proceeded to joke about my arranged marriage with the chief’s brother-in-law and how crazy fun the wedding would be with all sorts of celebrities in attendance. We really threw the wildest ideas out there and the secretaries in the room next door were able to follow every word. If they have a sense of humor, they thought it was funny. If they don't, they probably thought we were the cockiest, most stuck up and narcissistic people on earth. I love when people can get over the hierarchy of a work place and just have fun with one another.  

After a bit of stress, the natural nerve-calmer

Friday, I was once again a few minutes late to the morning meeting but that didn’t seem to bother anyone. I went on rounds with my resident. We did an ultrasound on a patient with the help of an attending. Its pretty nifty what a good ultrasound machine can show you. We finished up rounds and I finished up the blood draws before getting started on some release letters. Since all the computers were being used on our ward, I wondered to the surgery ward and hung out there to write some letters. I stayed comparatively late because the right moment didn’t present itself to ask if I could leave. I’m always bound to the train schedule so I have to think about the likelihood of me being able to leave ahead of time to have enough time to change and make it to the train station. If the right moment is missed, I have an hour to wait for the next train. I missed my opportunity to ask twice because my resident and I were so involved in the care of a patient with the attending that I didn’t feel it was appropriate to ask if I could leave. After missing both of the trains I had planned on taking, the resident finally said I could leave and could have left two hours earlier, she just hadn’t thought of telling me. Oh well, I’d rather stay longer and miss the train I planned on taking than looking like I’m trying to leave early and am not interested. Its just a constant battle of right timing.

This weekend, I am back in northern Germany to visit my grandma in the hospital and to babysit my godchild since her parents are celebrating their 2nd wedding anniversary. If all goes according to plan, she and I will go visit the Hagenbeck Tierpark, a huge Zoo in Hamburg.

And as a little treat, here are some of my pictures from the last weekend in Munich! 

Chiemsee

A moment of relaxation

Where to?

Looking for a new Dirndl

Pretty Bavaria

 

Week 39: That didn't go as planned...... at all!

Well that didn't go as planned.

This past week went everything but how I had thought it would. Monday was the most normal day out of all of them.

I came back to the hospital after the great wedding weekend motivated to work. Especially considering it was my last week in hematology and oncology and I had finally gotten to the point where I really, really liked working with my two colleagues.

Monday was a bit crazy as always. I spent the afternoon admitting patients and completing the usual long lists of examinations with them. The last patient of the day was a lady I had seen with the chief two weeks earlier in consultations. Since the chief is on vacation, I was the only one in the department who had an idea who this woman was. She has end stage pancreas cancer and let's just say her and her husband either don't want to accept the disease and acknowledge the scope of it or they really don't understand. She couldn't have the next round of chemo right away since she had elevated infection lab values. In their mind, once she gets the next chemo, the cancer will be stopped and she can live her life as it was before the cancer. The doctor and I tried to clarify some of the circumstances surrounding the disease but the two just kept being fixated on the chemo and that it'll be the cure. It isn't easy talking with them. I have no idea how I would be if I was in their position and every person is different and deals with such situations differently but the doctor and I just feel like we can't really help them grasp the scope of what is coming up for them.

During the Monday tumor board conference, I was flagged over by the chief of thoracic surgery. With a lot of brown nosing, he asked if I would be willing to assist in operations the next two days. I was sitting right next to my hem/onc doctor, he wasn't amused about giving me up for the days but sort of had to agree due to hierarchy.

The next morning, I got up earlier in order to make myself an omelet for breakfast. Not having been in an OR for a few months, I wasn't going to risk fainting. Since I had no idea when the operation would start (and not having access to the OR schedule since I'm in the internal medicine department), I snacked in between tasks and drank two cups of coffee being prepared for whenever the call came. It came at 10:30. I chugged a high energy drink and went to get scrubbed in. I most likely took in way more calories than necessary, had an overdose of caffeine and water in me but I wasn't taking any chances. (It proved to be a good amount of everything because I didn't feel fainty at any point during the 3.5 hour operation). I wasn't binge eating/caffeine drinking during my surgery rotation but my system was trained for long days in the OR. Not having operated in a while, I had to make sure I wouldn't feel sleepy or have low blood pressure (caffeine), wouldn't be hungry (high caloric drink, breakfast, KIND bar, chocolate bar) or thirsty (a liter of water) and made sure to empty my bladder just before entering the OR area. 

 

I think I ate about 11 of these throughout the week

I assisted in a partial removal of the right lung. It was a fun operation. Aside from the technical aspect of it all, the conversations we had while working were fun. The chief told that he didn't like the idea of me going back to the States. He offered me a job in his department. He proceeded to offer me a husband and house as well! He told me that his wife's brother is a really great guy, tall, good looking, works in media/broadcasting at a major German television station and would be moving to Hannover in October. The chief said he'd make sure I got a house in a nice part of town. He assured me the guy liked traveling and would love kids. In theory, it all sounded great. I threatened the chief with the prospect of having to deal with me a lot more if that all happened. He said he wouldn't mind. Oh man. This is just one of many situations I've had the last few months as my departure from Germany comes closer. Relatives are making me offers in hopes of keeping me around; “Vik, I have two private practices you could work in, the doctors there will be retiring in a few years and it can be yours!” I truly appreciate the love and effort and if I could live parallel lives, I would. If the States would accept my German residency I'd even consider it all. But the circumstances don't allow it if I ever want to work in the states and not redo my residency. I approach my return to the states with big time mixed feelings.

Wednesday, I took the elective student with me into the ER because she had never been and was supposed to assist the second operation. This time, we were supposed to go to the ER first thing in the morning. Again, I made eggs for breakfast, snacked along the way, chugged a coffee and a high caloric drink before entering the OR. Again, we took out a part of a lung. I was allowed to do a bit more this time around. Parallel, we all helped the elective student adapt to the new environment. She was lucky to have had such a great team as her first. It can sometimes be pretty ugly in the OR. Especially when everyone is stressed and gets snappy. That wasn't the case in the thoracic surgery OR however.

So after a quick rendevous with surgery, I thought the rest of the week would go as planned. That wishful bubble quickly burst when I woke up to a text message from my uncle (who at the time was on vacation in Italy) that my grandma had fallen the night before and was in the hospital. I called him, although it was 6AM. He told me that my grandma had fallen about 5 feet down. The miracle of the whole thing is that she supposedly didn't break a single bone. I called the hospital at 7AM, very well knowing that I wouldn't be able to talk to a doctor. The nurses told me that she had gotten through the night just fine and that nothing was broken but that they couldn't tell me more than that (something I totally understood due to confidentiality). They said it would be good if I stopped by to bring her some things. I partly laughed and told them that “stopping by” wasn't quite as easily done as said. It would take me 4 hours by train to even get there, not to mention I still had to go to work.

I had packed most of my things for my planned Munich weekend the night before, I threw in a few missing things (still missing things in the process as I noticed later) and took the train to work as usual. When I got there, I told my doctors what had happened and that I wanted to leave work as soon as possible and would be taking a vacation day for Friday. Nonetheless, I wanted to complete the intern tasks and not bother anyone else with them. I participated in rounds which seemed to drag on before leaving. I was bummed. I had looked forward to two fun days with the guys and those had to be cut way short. Obviously, fallen grandma trumps fun at work. I'm in the fortunate position as an intern to just take a vacation day without much notice (notice is appreciated but not mandatory).

I had to take the train to my home town first to drop off some things I had planned to drop off after work but had to be taken care of that day (otherwise I would have taken a train immediately to my grandma and not take the detour back to my hometown). I felt under extreme stress the whole first half of the day with all the running around and catching trains. Once I got to my grandma's town, it was a series of taxi rides to get to and fro from the house and get the key for my grandma's car from her at the hospital.

She is doing alright. Her back and ribs hurt understandably. Again, it is a miracle that my 85 year old grandma didn't break a single bone in that fall/tumble/stop. I was there too late to talk to a doctor. I already knew they'd be done for the day and the on call doctor wouldn't have been much help.

It is weird being so close to being a doctor myself and then having to be the patient's relative. I walked a fine line between doctor and relative, not trying to step on anyones toes but also fulfilling the tasks my uncle and dad had given me. I was especially considerate of the nurses knowing how annoying it can be to have a patient's relative constantly wanting to know something and even better, try to change something about the course of treatment.

This morning, I finally got to talk to the doctor. Again, I took steps to assure that I wasn't trying to hijack my grandma's treatment plan and that I respect and trust their work but that I had to be the messenger for a few of my dad's and uncle's questions/requests. I tried to avoid all the annoying things I've come to experience over the years of working in the hospital. I think I did an ok job and none of them dislike me....or at least I hope.

So although nothing this week really went as planned, one thing didn't change, the fact that I will be spending some days in Munich visiting friends and family. I might head back a day early and back up to Grandma if need be but otherwise I'll be back up in that corner of the country next weekend anyways.

Without further ado, I hope you all have a healthy and fun weekend!

V

Week 38: Live. Laugh. Love.

It was a bit of a crazy week last week. 

At work: I spent a lot of my time taking care of patients by myself this week. I don't remember having any longer periods of time were I wasn't actively doing something. My work involved doing the admission work for new patients. I'd take their history, physically exam them and then usually proceed with a list of things: accessing the port, drawing blood cultures, drawing routine labs and starting fluids or antibiotics. I also tried to fill out the orders as much as I could by myself. Much of Thursday afternoon and Friday morning were spent writing release letters.

Monday, I was assigned a patient and had to do the whole run down, including a bone marrow puncture! I was a bit nervous considering how the last time went. After successfully accessing the port, I felt a bit more confident. The elective student came and watched me do the puncture. So not only did I have to prove myself to my doctor that looked on but also had to perform well for the student. It...went....fabulously! It was so perfect. We got what we needed, no complications and I did a happy dance in my head! My doctor was rather relieved too. 
 

The face you make when EVERYTHING on your to do list works....including bone marrow puncture!

I felt like I bonded more with my colleagues over the past week. I was not a happy camper Thursday...not at all actually. The night before, I met up with some of the urologists for a scrumdelicious dinner and wine. I really only wanted to drink a glass of wine but the three guys kept pouring more....I was already hard core babysitting my drink but it wasn't doing much for my cause. The boys had their fun teasing me....seems to be a common theme of our meetings. I can handle it though and have my fun with it too. Before we all knew it, it as almost midnight! My brother was hitch hiking from Prague to my town. He didn't have a cell phone, so I couldn't call him and didn't know exactly when he would arrive. The doorbell finally rang around 2A.M. I had enough energy to let him in, give him a towel so that he could shower and told him he could make himself breakfast in the morning before heading out again. I was back in bed and my alarm clock went off 4 hours later.

Usually I do alright with sleep deprivation (I've had quite a bit of training with my night shifts) and this time I also wasn't really tired all day but I was in a terrible mood! I had reflux due to the wine. Everything and anything annoyed me. When I get agitated, I become really quite because I don't want to snap on anyone. At work, I was really quite and went about my business. When I was assigned writing release letters, I had to stop myself from complaining about such a normal task. For some reason, my colleagues at work decided to continue with the teasing my urology friends had done the night before. I took it in more or less silence and tried not to snap. It was a rough day at work for me but I managed to keep it together. After work, I wanted nothing more than to be in my bed. When I got to the train station and found out my train had a 50 minute delay, I really was on the verge of punching a wall and screaming.....I decided not to do that though because I was afraid they'd admit me into psych. Instead, I went to the department store near by and cooled off, bought a bag of candy and browsed clothes. It helped and I spent the last 20 minutes reading my book back at the train station. I was very happy to be in bed that night.

I took Tuesday off. My best friend from medical school got married yesterday. I made a stop in the lab Tuesday morning to get an introduction lesson for the new camera we got. It felt like Christmas! Much better quality! They also replaced the old, fat backed computers with a nice big flat screen one. I'm excited to get some work done with the new system. I just need to practice a bit more so things go quicker. 

Afterwards, my friend and I drove to pick up her wedding dress. She looked absolutely stunning in the last fitting. It got me really excited for the weekend. We headed to the church afterwards and rearranged the interior and raked leaves in front of the church. We proceeded to work off a bunch of things off of the to-do list. As her Maid of Honor, it as my top priority to do everything she needed done and to her liking. 

This past weekend, it was finally time for her to say "I do" in the church. It was such a fun weekend filled with great moments, laughs, tears of joy, dancing, eating, taking pictures, meeting family and friends and doing everything she needed me to do so that her wedding was exactly how she hoped it would be. I've known her since day one of med school. We weren't best friends immediately but always had the same circle of friends. In the second year of school is when we really found each other and have shared many experiences ever since. I was with her the day she met her husband, I was the one who went with her to an island to meet up with him and his friend which was a weekend that showed me that this thing was serious. I'm honored she chose me to be a part of her wedding as her maid of honor. Med school can be grueling and she and I really went through the good and the bad together. I'm so very happy for her that she found her partner for life a few months before ending med school and that I was around to witness it all!

Always have her back

The happy couple

My best and favorite med school girls!

Uh-oh, I caught the bouquet!

I have one more week of hematology and oncology left. That was quite shocking for my doctor to hear. When the attending asked me if I'd be around next week and I said it would be my last week in the department, the doctor stopped what he was doing, spun around in his chair and looked at us and said, "You're lying". I wasn't but his reaction made me feel good because he sounded disappointed which means it couldn't have been too horrible having me around. 

Stay healthy everyone!

V

Week 37: Cancer's many faces, Berlin's many masks and my many impressions

What an interesting week I had. I spent three days throughout the week shadowing the chief. 

After the morning meetings, I would go to the private ward with him and see the patients he was taking care of. At 10, we'd go over to the office building for consultations until about 1:30pm. 

It was interesting because I was able to experience patients in all the different stages of cancer that exist. Being in the room for the moment someone is told they have cancer is a weird feeling. Especially, if you know the person has cancer before they come into the room and you we waiting in anticipation for the doctor to tell them. Doctors have a difficult task of conveying the message appropriately. You need to use the right words, in the right order and on the level of the patients understanding so that they really come to understand what their diagnosis means. As soon as the patient hears the word cancer, everything after that is usually not being registered. It's also a tough task because not every cancer is the same. If patients haven't had contact to cancer patients, they usually assume the worst outcome. If they have had cases of cancer in their family or circle of friends, they only know that specific case. But cancer is so different and personal to each person. Breast cancer is treated completely different than colon cancer. The outcomes and prognoses are different. The journey through treatment is different. Even one type of cancer, breast cancer for instance, varies a lot between patients in respect to treatment, outcome and journey. Some are hormone or genetically sensitive to treatment, others aren't. It is important to give the patient a sense of were they stand. At the same time, statistics are statistics and don't really have a meaning for the individual. We can only say how long most patients live statistically, but in the case for a specific person, that really isn't relevant. Most patients want it to be though and ask about statistics. As a doctor, we walk a thin line between giving false hope and real hope. Even if we articulate an appropriate amount of hope, it is received and interpreted by patients differently so we have to see if that which we were trying to convey, was registered correctly. 

I few things I noticed over the week were:

A) Many patients try to attribute a certain life event to their cancer. "I fell a few weeks ago and hurt my shoulder, can that be the origin of my sarcoma?" (It can't.)

B) Patients that are married seem to handle it all better. (This was actually proven in a study.)

C) If the patient with cancer is the husband, the wife does most of the talking. "He's been taking these and these pills. He's been doing so and so with the treatment. His next appointment is then and then." Probably why point B stands.

D) A few couples would say "we" have this or that appointment coming up. "We've" handled the treatment this way. It really shows how much cancer doesn't just affect the person with it but also the loved ones going through it.

E) In general, patients with a worse prognosis seems to take everything a lot harder (understandable) but that isn't always the case and the attitude of the patient has a lot to do with their support system and their view of the rest of their life. Some are quite inspirational. 

F) Quite a few patients live with their cancer as though it is a chronic disease. I think that is still a fairly new concept for people. Medicine has gotten so good that even if we can't cure you completely of your cancer, we can, in some cases, push it back so far that your life expectancy is about the same as without cancer, it just involves taking a pill everyday. And as with any pill you take, you have the risk of side effects. 

Chief surprised us in the afternoon meeting with 3 scoops of ice cream for each person!

I think the chief really enjoyed having me around, explaining things to me and letting me do the ultra sounds before he did them to confirm my findings. I think he also appreciated that I know how to politely deal with people. I think there is just a certain way you have to act if you are working with the chief because the patients have certain expectations when they come to consultations with the chief and it can't hurt to be greeted and escorted to the room by a friendly student. (And I'm also friendly to all the other patients too so it isn't like I'm trying to be any different than usual which makes it easy for me.)

Back on the ward, I finally got to do a bone marrow aspiration! It didn't go as smoothly as I had hoped it would but no unexpected harm was done and we got the material we needed so all good in the end. I just wish for myself that it had gone better but it was my first time so I guess it went well. I didn't accidentally go through the other side and do a colon biopsy (which as funny as that may sound, was my greatest fear, even worse, puncture a big vessel.) 

A good idea of what I did.    Google Images.

I'd also like to tell you about a situation with a patient because I think it is a good example that just because medicine is capable with doing things, it mustn't always be done if discussed openly with the patient. 

The patient has cancer. He's gone through chemo and was taking pills as the last option of treatment. The pills statistically could make him live a couple of months longer. While taking the pills, he suffered from gastrointestinal side effects and they left him not enjoying food anymore. He just didn't feel good in general under the therapy with the pills. He decided to take a break from the pills knowing that would statistically lower his life expectancy. As we talked with him, his wife, daughter and two grandchildren were in the room. He looked as though he was a normal old man enjoying his time with his family but you wouldn't have been able to tell he has cancer. After openly discussing with him the statistical benefits weighed against the reality of how he felt taking them, we all agreed that it would be better to take a break from the pills for the time being. If need be, he could always start them again. In his situation, I would have done the exact same thing. He weighed being under treatment and feeling bad, not enjoying life with feeling good, being able to enjoy life and statistically maybe living a few months less. But isn't a life you enjoy living and your loved ones can enjoy with you worth more than being able to say you lived a few months longer but weren't able to enjoy that time? It is a highly personal decision a person has to make for themselves. I thought it was a nice conversation to have witnessed. The doctor didn't push the medicine because of statistics but rather treated the patient as a whole and not as a disease that needs to be cured.

Similar situations happened during consultations. There was one situation though, were I as the patient, would have decided differently. The woman has cancer. Due to a certain factor she "luckily" has positive in her type of cancer, there is a pill that works highly specific and targets the caner cells which gives her a significant statistical advantage for survival over not taking them. The common side effects are also easily manageable. She decided she was done with medicine and was not going to go through with the therapy. This was rather baffling to me (especially with her medical professional background) and the chief was also not for her decision. Seeing that Germany is a free country and we can't force anyone to do anything (and our mentality isn't such that we would) the chief explained the benefits to her multiple times in the hopes that she might see the benefit and change her mind. After repeated attempts, he told her that his suggestion for treatment stands and that he wasn't going to change his recommendation but that he had to respect her decision even if he doesn't agree. I can live with situations like this when the patient is an adult and has understood the consequences. I have issues when these situations happen with children and their parents are the decision makers. Many things, if need be, can be done with a court order. Other situations, such as vaccinations, are a different thing. A big reason why pediatric medicine, although lovely on so many fabulous levels, will probably not be the area I work in. 

That was my rather interesting week in Hem/Onc. Two more weeks to go. The chief is on vacation the next two weeks and starting Monday we have an elective student in the department. I'll take over mentoring her a bit to see where she stands with drawing blood, placing lines and such.

Now a little travel report for those that are interested. :)

I spent the last weekend showing my friend from Miami a bit of Germany. We met up in Hamburg on Friday. Took the train to Berlin Saturday morning and both left Berlin Sunday evening. 

Christopher Street Day was going on in Hamburg. There were booths with drinks, food, tightly dressed men, rainbows and loud music all around. We took a stroll through all the festivities. The big department store Alsterhaus and the town hall both had pride flags displayed. I thought it was an incredibly cool symbol from the city to show support for the event. Germany in general is a very accepting country. Many might not associate that with Germany right away due to its history but we have acknowledged our past and dealt/are dealing with it. Nowadays, I feel it is one of the most accepting countries I've been in.

East Side Gallery shenanigans. Berlin

If you are in Hamburg, are starving and can't decide what you want to eat but just want a good variety of food immediately without having to look for a restaurant first, I suggest going to the LeBuffet on the 6th floor of the Alsterhaus. It has a buffet with a wide variety of food at a good price and a view on the water!

If you are in Berlin and want some really delicious Arabic food, you must go to Casalot (Claire-Waldoff-Strasse 5)....SO delicious and the presentation of the food is also outstanding. The service is very friendly and the place offers a lot of outdoor seating.

Pretty gelato flowers from Amorino

A restaurant I wouldn't suggest going to is DIE EINS (Wilhelmstraße 67A, 10117 Berlin). I hate to give a bad review but this place can easily be a tourist trap. It has a very nice location right on the river, around the corner from the Brandenburger Gate and a hop, skip and a jump away from parliament. My friend and I were just so starving that we sat down. Before even ordering I had a feeling the place relied highly on its location and could therefore care less about the food or its presentation. I ordered something of the breakfast menu (seeing our breakfast to that point had been a felafel, coffee and half a KIND bar). Granola with milk, quark (its German, think of thick yogurt) with berries and honey, fruit salad and fresh squeezed orange juice. That sounded really good to me and I could think of multiple ways of presenting that nicely. In reality, I was served a bowl of cornflakes with a few walnuts of top (how fancy), the quark was basically runny yogurt with jam in it, the fruit salad contained many broken grapes and in general was not that appealing. The fresh squeezed orange juice was 100ml....didn't feel like much more than a shot. It was just bad. I easily could have made a better meal at home for far less. My friends omelet and salad didn't look or taste half as appealing as the menu made it out to be. So if you aren't starving, avoid this place and go down a few streets for something nicer. 

Some fun in a store that encourages taking pictures: maskworld.com Store Berlin

Saturday evening, we stumbled upon the Monbijou Theater Strand Bar dance event. Every day of the week, they have a different DJ playing music and a dance floor set up right next to the river. You can get drinks and order Pizza and it is just such a lovely atmosphere in a lovely part of town. We sat down for a good long while and watched the couples glide across the dance floor. I seriously need to take my grandma up on her offer to pay for dance lessons to learn the standard dances and then I have to get my booty out on that dance floor someday! 

We did a Free Walking Tour of Berlin on Sunday. It takes about 2.5 hours and its great! While back packing through Europe, my travel buddy and I would often partake in them. The tour guides have always been fun and were really enthusiastic about it. They don't give you boring facts and move on, the stuff they talk about is interesting and explained well. A great part about it, and their business model, is that it is absolutely free and the tour guides work on a tips basis only. This makes it easier for students who might not be able to afford as much to decide what the tour was worth to them. If I had the extra funds, I'd probably be giving them double what I do because I always enjoy the walk so much. Great way to see the important things in the city if you have limited time. 

That is all for now my friends! Stay healthy!

V