You would think that, but there is an icon for not using a dryer. There is an icon for all forms of drying. On a clothes line, in the shade, "flat", ...
<the typical German philosophy of strictly following the process -- as absurd as it might be -- and refusing to take initiative for anything that is not explicitly defined as one's responsibility>
you summarized my 5+ year experience living in Germany with one sentence in a way that I have never found the words for - thank you, really, thank you
I feel that in Germany, the original intent of the many rules, processes, and procedures has been lost. Employees are trained to operate such that every situation is governed by a rule/process/procedure, and their job is to look up the situation in a massive leather-bound book of branching rules, see which rule applies in the given situation, and then… apply the rule. But, they will do this only if they assess that helping you falls under their job’s responsibilities. Sometimes your situation is neat and clean, and was what the rule-writers thought about when they wrote the rules. Sometimes, not.
TLDR: if you have an edge case in the German bureaucratic system (forms at the doctor’s office, Deutsche Bahn travel troubles, closing a bank account), you are f***
It is certainly my biggest dislike factor with my stay in Germany, and I'm still struggling to come to terms with it: do I dislike it enough to compel me to move away? is this something I can accept? How much can I influence and improve things that I directly interact with?
It seeps in everywhere too, with almost all aspects.
Day-to-day with restaurants, cafe, shops. Almost all interaction feels like it's actively checked if it's in their process or job description. Shop staffs are typically disengaged and can't really help you with anything outside the normal process.
Healthcare, both receptionist and doctors. You can see the rushed service because they are only compensated for limited amount of time by the state insurance. This took me a while to figure out; the process really defines what treatment you get, with what equipments, as well as the duration, and they have to do their best with the constraints put by the process.
An example: with Wurzelkanalbehandlung, the process says (at least back then) only 1 hour of Laborkosten can be compensated by the state insurance. This means if the dentist took more than 1 hour to work on you, that would be done at their personal loss, and thus the incentive to rush the procedure.
Going private helps (they tend to be more relaxed after the mention of of Privatzahler, and gives you access to newer equipments not yet acknowledged by the state insurance processes), but you still have to research, find, and pick the right practice.
Bureaucracy, administrative. You often have to deal with clerks that just go "I just work here", the rules says this and there's nothing I can do, throws hand in the air. Goodbye, next person please!
In day-to-day work, I can also see it. New hires tend to be more into the work, and questions things, but the system does push everyone to just follow the process and not do anything more. I've seen my colleagues slowly shift into this mode, delivering what is outlined, nothing more, not questioning the intent behind the work (or at least, doing it much less than before, because the system does not incentivise that).
I would summarize Americans (and perhaps most English speaking countries) as perceiving this mindset to be callous, ineffective, and a dereliction of autonomy.
But I'm interested in how Germans perceive Americans in reverse? If shop staff went out of their way to help them find a product, shoot the breeze, or recommend a lunch spot, would Germans tend to see this as being overzealous? Would it cause embarrassment, or be a pleasant surprise? Just curious.
I tend to view shop staff having a random talk with someone while I’m waiting to purchase or ask something as a dereliction of duty. If you want to catch up with a friend you can do it on your own time.
Every country is different and you need to learn slightly different ways of dealing with them in each. On a bad day it can be pretty exhausting.
It turns out, people everywhere want the same things, in the end. They just go about them differently.
In Germany, it often helps frame it as both of you trying to work with the rules together; as a framework to build within and on, rather than a cage to hold you in.
Doesn't always work. Nothing works all the time, (especially if the other person is having a bad day themselves and just wants it to be over). But if it helps even once eh?
The difference in healthcare between private and public insurance is, as far as i know, because if a doctor sends you for some test or something that your insurance feels was unnecessary then the doctor has to pay for it with the public flavour. At least, that’s what I heard but could be wrong.
Interesting that GLP-1s might have different effects on cancer _incidence_ vs. cancer _survival_.
A different study "GLP-1 Receptor Agonists and the Risk of Thyroid Cancer" was published in the Diabates Care journal in February 2023*
The conclusion of the 2023 study: "we found increased risk of all thyroid cancer and medullary thyroid cancer with use of GLP-1 RA, in particular after 1–3 years of treatment."
I wonder what the mechanistic hypothesis could be for GLP-1s increasing thyroid cancer _incidence_ (the probability of thyroid cancer occurring in patients taking GLP-1s) but increasing colon cancer _survival_ (the probability of surviving in patients taking GLP-1s who have colon cancer).
Of course there are numerous important differences across the studies (cancer type, France vs. USA data, etc.), I'm just curious about a why this might be the case.
I'd be cautious for the same reason: thyroid cancers are also positively associated with obesity, and people who take GLP-1s are often obese.
Below a table, it says "adjusted for social deprivation index, hypo- and hyperthyroidism, and use of other antidiabetic drugs..." -- but nothing about obesity.
What if the GLP-1-prescribed patients tended to be more obese?
I think this analysis is cool, and the comments are too critical. The author put something out there, documented it, and I learned something by reading it. Thank you.
Maybe the title needs reframing to soften the reader’s expectations, and I definitely agree that RA as a data source has important limitations that should be mentioned.
I strive to be at the informed part of the spectrum.
Wine example:
- Novice: "I'd like any red wine" -> waiter brings you something you don't like
- Informed: "I'd like a red wine that is dry, not st" -> waiter brings you something you are quite likely to like
- Asshole: "Do you have an Argentinian malbec from 1998-2000, from the so and so valley?" -> you spend a lot of money and like the wine, or you are unhappy because they don't meet your asshole preferences
Keep pushing through the asshole stage and you get to another where you learn to enjoy what you enjoy, whether it is a $10 chocolate chip cookie or Chips A'Hoy. A $200 bottle of wine or a $5 bottle.
It is possible to dig deep into subjects and emerge with a nuanced understanding rather than an asshole demeanor!
I've kept aquariums basically my whole life and have had all kinds of critters including a really expensive marine tank fully kitted out with fish worth hundreds each. My current favorites are some guppies I got for free because it wasn't worth charging for them!
> - Asshole: "Do you have an Argentinian malbec from 1998-2000, from the so and so valley?" -> you spend a lot of money and like the wine, or you are unhappy because they don't meet your asshole preferences
So asshole is having preferences that don't fit the norm? If they don't impose their standards on you, and do not act a snob, why do you care?
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