This is sort of a response to my good friend Stephans blog post about his experience during his alternative national service (I’ll refer to it as common german word “Zivildienst” further on) . “Sort of” because it’s not really responding to what he wrote, but picking up the topic and my own experience to the story.

Stephans experience was apparently rather extreme. Although not totally uncommon I’d say. And to a certain extend it reminds me of my own service. But let’s start at the beginning.

To me it was clear that I would not go to the military. I actually quite liked the physical side of it. But I knew I’m absolutely not the person to take orders blindly and without questioning its sense. So I applied for alternative national service – a.k.a. Zivildienst. Fortunately in the mid 1990s that wasn’t really that uncommon and would be granted with a minimal piece of paper explaining some reasons.

The majority of the positions in Zivildienst were about working with people. Primarily elderly people in day care or home care setups. Or in hospitals. At least those were the positions I somehow was familiar with from friends and family.

Fresh out of school I wasn’t really into taking care of people to be honest. Taking care of basic needs, daily hygiene etc. didn’t sound compelling to me (to whom would it in your late teen years?). A widely accepted sloppy description of Zivildienst was to wipe old peoples bottoms. Not something you dream of spending a whole year with.

So I searched for less involving positions in the area I would live in (Hannover back at that time). I was thinking of something as janitor, carpenter assistent etc. Really anything but working with people if possible. Eventually I called the HR department of a hospital nearby to aks whether they have Zivildienst positions in their nursery or repairshop. The HR lady was really clever. Instead of answering straight away she asked what I plan to do after my Zivildienst. Without much hesitation I openly answered that I was indeed considering studying psychology. And so her trap snapped. She said that in this case she’s got the perfect position for me. They have a special station for lung cancer and looking to fill the zivildienst position in there. The job would be quite easy going as most of the patients are fit and don’t need care. It would be just making the beds and deliver the food. There would be plenty of time to talk to the people, take them for a walk etc. She made it sound like a walk in the park literally. The only remark she made was, whether I would mind if occasionally one of the patients might die. In the end it was still a cancer station.

What did I know about the world and cancer in particular back then? Pretty much nothing. So I accepted and thought this was a good deal.

Technically the HR lady was right. The majority of the approximately 50 patients we had were quite fit and didn’t any care at all. But there were always these one or two who would make up for that. These patients would need rather intesive care for various reasons. That means they required help during every activity. From washing to dressing to taking their meals and … getting rid of the products of their metabolism to use some less colourful words here. There were also a bunch of tasks that most people would find disgusting. Taking care of the disposal of all sort of body liquids and cleaning the respective equipment. And guess to whom such tasks would be assigned to? Or course the person lowest in the pecking order. That would be me – the Zivi (short for the person doing the alternative national service).

To my big surprise those tasks didn’t bother me at all. They were smelly and really dirty at times. But it turned out I have no sense for “disgusting”. To me it was just work. And even more surprising – I really enjoyed working with the patients. Especially the ones that needed intensive care. I would often spend almost my entire shift taking care of those. Some of them were physically impaired and needed help dressing and washing and getting to the toilet. Some where mentally impaired and also needed help for all sort of things.

I loved the direct feedback of my work. The patients where very thankful that someone would help them and treat them with some dignity. Someone whose face didn’t cringe when changing adult size diapers and cleaning bed pans. Being in the hospital itself is very difficult for the patients anyway. Being dependent on someone elses help to take care of basic human needs adds even more stress to that situation. When they felt that the job wasn’t a burden for me but sensed that I was truly happy to help them, it eased their situation at least a little bit.

To the patients which needed more intensive care I naturally developed a more intense relationship because we spent quite a lot of time together. I had one man who suffered from multiple sclerosis and couldn’t really use his legs and arms anymore. In addition he had an emphysema and the doctors decided to cut a window in his chest to let out the excess wound water. This poor guy couldn’t really do much on his own and I had to spent almost my entire shift taking care of him. I’d bring him to the toilet, wipe his butt, take a shower with him and take care of his wound. Through that window in his chest we could see his heart beating. One day we took a torch and a mirror to show him his beating heart during the changing of the bandages. This guy was really tough as despite all his suffering and impediments he had not lost his humor. We would usually joke around when I helped him dress and do his bandages. But there were also the other days when he started to cry because he was embarrassed that I had to hold his bad bed pan while he tried to relief himself leaning against me (due to his paralyzed legs he couldn’t easily sit).

And there were many of those awkward and intimate situations that but have the opportunity to form a special bond between the people. These were all chances to show compassion and dignity.

Eventually some of my patients died. It was cancer station nevertheless and for some diagnosis was final. The HR lady slightly understated the number of deaths in our initial interview. After one year of service I counted 52 deaths. That was much more than I originally expected. This was the first time in my life I saw dead people in real life. One usually doesn’t see this. Death is pretty much shielded from normal day life. But at the our station it was some sort of normality. This may sound harsh, but that’s what it was. And the special talent of the staff was to deal with it in a way they kept their own humanity, sensitivity but also sanity to ones alive. While at the same time accepting they they might be dead the next day.

Also this aspect of the job was surprising to me. Handling the dead bodies is certainly something out of the ordinary. But even that did not bother me at all. Not even the fact I might have taken care of the person just minutes ago. There was but one very emotional moment when a little English man who knew he might die soon realized that. He asked me in German with his englished accent “Werde ich sterben?”. That’s a question one usually isn’t prepared to answer. In that situation I couldn’t even imagine a proper answer. So I honestly said that I don’t know. But asked him what he believes would happen after deaths. He was a religious man. At least theoretically he knew that deaths is not a final end. So we talked a while about what he believes and hopes would happen when he dies. This conversation seemed to calm him down and put him a little at easy of what lies ahead. He eventually died that night.

The next day I asked the coroner whether I could attent his autopsy. I was curious how people look inside for real. It was amazing to see thing in real life that I’ve only seen in books before. Where all the organs are and the blood vessels and bones etc. Over the course of the year I attended 6 autopsies of my patients and learnt a lot about the human body first hand.

Overall I enjoyed the Zivildienst so much that I was actually considering doing this as a job. Rarely had I a job later that was so satisfying. The simple but direct impact to other people’s life and the difference one can make was astonishing to me. But I also learnt a lot about myself.

After I finished my year they had two more people trying to do their Zivildienst there. The first one had to be moved to a different position in the hospital as he couldn’t deal with special situation of people dying on regular basis. The second candidate had to abort and go into psychiatric care.

My utmost respect to all the people doing this job with dignity, professionality and love.