Heather Satterthwaite had been in Germany only two days when she awoke to the murmur of nurses and doctors speaking in an unfamiliar language.

The 19-year-old newlywed and her husband, Stuart, an airman stationed at Spangdahlem, had been in a head-on collision en route to Bitburg.

She asked for her husband. The word "husband," however, confused the hospital staff; a German woman refers to her partner as "my man."

Patient liaison Jaeline Perry was summoned to help; she had been attending to Stuart Satterthwaite, who was in the intensive care unit in a coma. Perry asked, in English, if Heather remembered her own name. She did.

"She was lost, waiting for someone who spoke her language," Perry said. "At that moment, you’re the first one they can reach out to and tell their story."

With bases closing around Germany in the 1990s, the military contracted with local hospitals to provide care for patients who otherwise would have had to travel miles.

It’s an arrangement that has proven successful thanks in large part to patient liaisons like Perry.

Liaisons fill out paperwork, speak to doctors when needed and explain the many differences between German and American hospitals, such as why there are no private rooms or paper thin, sea-green dressing gowns best known for not covering the backside. German patients wear their own pajamas, but the liaisons keep a stockpile of gowns for any American who wants one.

The liaisons work for the U.S. medical units at each base. Many are on call 24 hours a day.

Closings spark need

Prior to the 1993 re-unification of Germany, more than 270,000 troops and about 500,000 family members were treated at eight Army hospitals and more than 56 clinics across Europe. By 1995, only three hospitals and 28 clinics were left.

Now, there is one Army hospital at Landstuhl.

With fewer troops, the expensive and elaborate medical facilities were no longer needed. At the remaining hospitals and clinics, specialists were replaced by general practitioners, and soon servicemembers and their families were being referred to local hospitals when they needed surgery or other specialty care.

The patient liaison program, which started in 1995, has proven to be such a success that five liaisons and five case managers will be hired to assist American patients in South Korea.

"They’ll serve as the conduit between the Korean hospital and the patient, and essentially be there to help navigate the health care system," said Haleh Rollerson, Tricare health care chief for the 65th Medical Brigade.

One of each will work out of camps Casey, Humphreys and Walker; two of each will work from Yongsan Garrison.

Both brigade commander Col. Jeffrey Clark and Brian Allgood Army Community Hospital commander Col. Ronald Smith, served previously in Germany and agreed to model the new program after Tricare Germany’s liaison programs, Rollerson said.

A similar program is in place in Japan. U.S. Naval Hospital Yokosuka employs a case manager and Japanese doctor interns to help patients who use Japanese hospitals, Yokosuka officials said.

About half the liaisons have worked in the medical profession in some capacity, either as nurses, physical therapists, or physicians’ assistants. To become a liaison, they must show a command of medical terminology, said Lesley Lehwald, patient liaison and ERMC consultant.

"But we’re in a clerical position," she said, "so you can’t ask for nursing qualifications."

More importantly, the liaisons speak both languages well and can intervene when the doctors have trouble communicating.

It’s not that the doctors don’t speak English themselves. It’s that "things don’t always translate well," said Simone Harcarik, who heads the Spangdahlem’s patient liaison program.

Since the U.S. hospital in Bitburg closed two years ago, Spangdahlem’s airmen and their families have been treated at the local German hospitals in Wittlich, Trier and Bitburg.

Births made easier

Now that German hospitals are attending to routine care, too, liaisons are being called in for most of the American babies born.

Harcarik recalled a nervous, expectant mother being told by her German doctor "to go home and keep quiet."

"He was trying to tell the girl that everything is all right and to go home and relax," Harcarik said. "But he was translating from German to English, and German is a very direct language."

Witllich’s Dr. Peter Locher, an obstetrician and gynecologist, said the liaisons’ language skills are especially beneficial when complications arise.

"We’ve had two cases of stillbirth," Locher said. "You don’t expect it, but you still have to deliver. They gave support to the patients. They explained that we did all we could."

Since the program started, Locher has delivered 155 American babies and has become accustomed to the lists of questions new American moms tend to have. German patients are less likely to question their doctors, he said.

"The patient is more independent," Locher said of the American health system. "They make the appointments. In Germany, it’s usually we who make the appointment."

As they interact on the ward, though, the American mothers have influenced their German counterparts.

"Some of my German patients are now coming in with lists [of questions]," Locher said.

At the Bitburg hospital, 13 babies were born in January, and the patient liaisons guided the new moms through every step.

"Some women you get to know from day one until they leave with that baby," said Dagmar Ham, a patient liaison at the hospital in Bitburg. "You see them struggle. They show all their hormonal emotions and then they have their baby. It’s beautiful."

Because of deployments, the liaisons are sometimes even in the delivery room, holding a mother’s hand as she gives birth.

"You wonder, ‘How did I get here?’ " said Harcarik. "But they’re happy to have someone there to sing happy birthday to their new baby."

But a liaison’s happy moments can be short-lived. "Sometimes you go from someone with a baby to a patient who is seriously ill," said Alwine Ramirez, a liaison in Trier.

Many of the liaisons carry mementos given to them by favorite patients. Harcarik keeps a poem written about her; Ramirez has a small crystal, which was given to her by a young airman who needed psychiatric help.

"He found that crystal when he was a child," Ramirez said. "It means very much to me."

Heather Satterthwaite, 20, remembered how kind the liaisons were to her while her husband was still in a coma. Fractured vertebrae had left her unable to walk, so the liaisons wheeled her to the intensive care unit to see him.

"They made the doctors talk to me so I knew what was going on," she said. "They updated me on him every day. They brought me magazines and candy."

After her husband awoke from the coma, the liaisons placed a jar by his bed for dropping in thoughts or concerns he’d jotted down.

"They called it a worry jar," she said.

Eventually, her husband recovered. After nearly a year of physical therapy, he has returned to work at the security forces warehouses, and she is now pregnant with their first child.

"Now, [the liaisons] are going to be at the ultrasound," she said. "These are going to be much better memories."