Deep brain stimulation (DBS) in 24 Neurosurgery clinics in Germany

Our daughter came about 6 weeks early tonight. The entire team at the children's clinic really took great care of us, my wife was looked after very well and everything else was also explained to us very well. Many thanks to the sisters who supported us so well during the birth and guided us through everything in a relaxed manner with so much patience and empathy

Worst hospital in all of Bremen! On the evening of September 20, 2023, I was at the doctor's on-call service due to severe abdominal pain. When I got there, there was no one in the waiting room and I was taken straight away, which is actually very good. But when I described my symptoms, I was immediately insulted as to why I was coming for a stomach ache and why it was costing me unnecessary money would cause and that stomach pain is normal etc. and the doctor was extremely rude! I wasn't checked either and was sent straight home. I don't remember the older doctor's name. But he definitely wasn't interested in his job. I was so shocked that I left in tears. Of course my pain didn't go away and 1 day later I went back to the emergency room at St. Joseph Stift Hospital and found out that I had appendicitis + inflammation in the ovary. Very very disappointing this hospital, especially this doctor.

Everyone was lovely and caring hospitality team is great 👍

This is my experience and includes my feelings. I can't understand many of the reviews here. The employees were more than friendly and helpful. The nurses were all equal, friendly and accommodating. Personally, I didn't have the feeling that there was a lack of skills here. Regarding the food, I have to say that it was more than varied and delicious. In my opinion, the portions are also completely sufficient and if someone is there just for food, there is also a canteen that offers delicious food, no one really has to go hungry here . I would like to thank this clinic very much for doing a good job at short notice and, above all, more than competently in an emergency despite the high volume. Maybe you should stop seeing a hospital as a vacation or a hotel and be grateful that you are helped here. I have absolutely nothing negative to say. The hospital was clean, friendly and competent.

The family doctor sends you to the hospital (emergency ambulance) and you sit there for an hour in the waiting area, only to be told that they don't have a surgeon and they can't do anything. So this hospital is getting more and more ridiculous. 0 stars if it were possible.

The fact that something like this persists in Germany is another sign of our ailing health policy. I was here on a course. I got increasing pain in the left upper abdomen. I tried camomile, heat and pills. When it got worse on the third day, I went to said emergency room. From here a disaster. I was made to wait, then an assistant came, questioned me, took the typical vital parameters, put in an access and took blood and said goodbye. She worked with long artificial fingernails, which I consider extremely questionable and unprofessional in this area. After another hour, a doctor came, asked how things were going, sent me for an X-ray and said goodbye. Two hours later and a few questions, I found out that this doctor is closing time and a new one is coming. This one came too, BUT. He clearly came from Africa and spoke very bad German. He then wanted to do an ultrasound, I'LL GO ABOUT HERE, he prepared everything and then... he couldn't operate the device. He then broke off, saying there was nothing. I asked what the X-ray revealed. He didn't know about an x-ray, but wanted to ask. He came back after a whole hour and didn't answer me, wanted to send me to a room. I asked about the X-ray, he said bluntly, he doesn't know anything about it, but if anything happened, he'd find out. He didn't go into the blood. I released myself, walked to my apartment in pain, packed my bag and drove home. A look at the blood count made me suspicious, my inflammation levels were extremely high (I used to work in the emergency services) At Großburgwedel I drove down because I almost had an accident, couldn't breathe and could hardly sit up straight. I crawled into the emergency room and was on the verge of collapse from the pain. They took me straight away. listened to my story Doubted, looked at the papers and were amazed. If new blood was drawn, asked for the diagnosis "meteorism", I denied this. Ridiculous. I was given tilidin for the pain. I was fine in no time. Blood work came and the inflammation levels were not higher. An ULTRASOUND was done. Water in the pleural space.... That's simple medicine. Neither the blood was detected, the x-rays gone, and no ultrasound... A shame and actually I should sue the clinic!!!

My worst experience in a hospital for far. My room is beside a place that are remodeling, 12 hours of the sound of a hammer constantly. Due my operation I can not eat solids, so the only thing they are offering me is pocket soup, no veggies no fruits, nothing. And forget about to find the manager, she is never in the office, and she will never pick up the phone. The personal in my station are good the most of them, the problem in hospital is systematic.

The most irresponsible and unprofessional team I've ever met. My oparation was cancelled one day before the last minute, after all the preparation. Even worse, for more than one month, no apologize, no explaination and no call back to arrange a new time for the oparation.

Worst hospital I have ever been too. They are under staffed and under funded and care more about making money then care of patients. Cancelled appointments without letting patients know due to broken equipment and staff shortages. You would get batter care in a third world country hospital. Asklepios is a shinning example of how broken the German Medical System is.

The worst experience with the treatment for an international patient. The hospital arranged for us viewing for a cardiology patient. We travelled from a far away to be there (having paid a huge lump some that was supposed to be used for the tests etc). Instead - the person who took blood tests did not even wear PPE, the doctor who saw us had not even read our history (having sent if a month before), did not do any meaningful tests that would bring us to the diagnosis, still waiting for the anamnesis (and prescriptions) to be sent to us after over two weeks.

Thank you so much to the orthopedics team and everyone at station M120. They gave me a new ACL after I tore it, the operation went perfectly, and the care I received after was outstanding. I prepared for the worst, but the friendliness and professionality of the staff made everything so, so much better.

The staffs are friendly, and they saved my friend, so 5 stars for sure. However, if it’s possible, I hope I’d never need to come here even they have a great view outside of the window. Stay healthy 🤲

Very kind and caring staff who took care of me when I was admitted with an ambulance in the middle of the night. Big respect!

Good services, but the emergency wasn't fast! Reception of emergency was so unfriendly, and rude!

Experience with this hospital could be described in two words - HORRENDOUS and UNPROFFESIONAL.. At the reception they lost my ID card. After two phone calls and one visit, the hospital reluctantly assured me that they didn't have it, which is why I couldn't fly back to my country and my flyticket was forfeited. After a few weeks, without notifying me by text/call/email (even though they had all my contact info) they sent me this ID card by post (after it had already been blocked).. The invoice that came home cost 190 € even though the hospital told me the price would be around 60 €. This whole situation was made worse by the unhelpful and unpleasant attitude of the staff. It had cost me lot of time and money and the hospital didn’t do anything to make up for the inconvieniences caused.

I went to this clinic for an emergency case and an ent (ear, nose and throat) doctor saw my ear and gave me an ear drop with a nose one. The staff was very friendly and helped me with English speaking. They even have the registration form in different languages. Great.

1. Nobody speaks English in the Information 2. They send me to have a corona rapid test to a apotheke/pharmacy a few meters away, while I was hurting 3. The doctor didn’t check my breathing, my heart pulses, my blood and yet he diagnosed me and gave me pills Well guess what happened after 3! I had to go again to another hospital because I was not able to breathe properly! The hospital must be shut down and this doctor needs to get fired! Thank you for your non-existence services!

The most unruled and random hospital in bremen you will wait long time and after that they will tell you all doctors are busy come next time and they also lost my documents and insurance they told me we cant find your papers and i just come today and i give my papers today how they lost it i really don’t understand.. i waited a long time till now they didn’t get my all documents that they already took it’s really bad hospital!!! 0 RATING NOT EVEN 1

amazing, sympathetic and helpful people. did not get mad at me for speaking english and was not a long wait. thank you!!

First something positive: the doctors, especially the anaesthetist, were good. However, during my time on the station following ankle surgery, I was shocked. 1. When i woke up after the surgery I hadn't eaten since the day before (it was around 7pm), I asked a nurse if i could have something to eat and she shouted at me, made me feel like it was a totally unreasonable request - the other patients in the room were shocked and defended me. Finally she brought me some food but was clearly annoyed that i had asked for something so basic. 2. When I realised my period had started during the surgery, I was once again shouted at for asking for help to get a pad (I wasn't allowed to leave my bed to go to the toilet so soon after surgery.) It was humiliating. I was left in those bloody sheets for 4 days 3. I had a very big ankle surgery and was in pain I had never experienced before (including childbirth), the nurse during the night shift straight after the surgery refused to give me anything stronger than Novalgin and then left me for 6 hours with nothing else. She told me to stop ringing the bell because she couldn't help me. I was sweating and shaking with the pain. Pain management continued to be an issue throughout my stay depending on whether the nurse on shift 'believed' my pain or not, I raised this with the doctors several times. 4. I told the staff that my bandages felt too tight and no one listened to me, now 6 weeks later, i still have nerve pain, which needs pain medication and skin necrosis from having extreme pressure on my foot for 2 days. 5. One evening a nurse filled every patients' thrombosis syringe half with air, thank goodness the other nurse on shift realised before she injected 16 patients with air, she was in disbelief. This added to the general feeling of not being safe on the ward of this hospital. 6. Nurses were exhausted and burned out, 2 nurses for 16 patients is clearly not enough. 7. When i wanted to come back after 6 weeks to discuss the surgery and recovery with the surgeon I had to beg for an appointment on the phone to a very rude receptionist (the same receptionist who a few weeks before told me there is no plaster cast in the hospital, can this be the case in a hospital with an orthopedic department and an emergency room?!). After care is a simple responsibility after major surgery, especially when there are complications such as crippling nerve pain that my general orthopedic doctor couldn't seem to explain. To say I was shocked is an understatement, I feel traumatised by this experience. Sometimes I have nightmares about being back on that ward crying in pain with no one helping me. The experience was inhumane and I deeply regret choosing this hospital. I have never written a review like this but i feel a responsibility to warn people. Once again I will say the doctors were good, but you rarely see them. I particularly appreciated the anaesthetist who showed compassion and diligence but that level of care should be the rule, not the exception.

I was at the clinic with my wife and every single nurse, doctor, security and receptionist that talked to me were patient, kind and nice. Although I don't speak German, everyone was willing to explain things in English. Special thanks to a nurse and a doctor both called Julius who were extremely kind to us and treated us like real human beings. I'm full of gratitude to everyone in this hospital. Thank you 🙏🏻

I was travelling from England on a motorcycle with friends to travel through the Pyrenees and the alps, it was the most beautiful sights I’ve ever seen then into the Black Forest, then I had a terrible accident and was smashed up badly, I was take by helicopter to university hospital where they repaired my broken bones, they saved my life, they were very good to me and I will never forget, I was in hospital there and back home for a couple of months, the end result I’ve led a near normal life, thanks to the surgeons who expertly repaired me, I will never forget,

i went for my yearly check but was told it cant be done if i do not have one of the 3Gs. i was told to get another appointment although the hospital websites states otherwise.

Every time I go there there is a different doctor. This time she spend most of the time typing away and looking at the computer. She was friendly but I got nowhere. For the past two years it's always the same. I have severe pain in my back and a few other parts but it's always a complete waist of time.

Completely rude and incompetent stuff , I went once to emergency , as I am first time pregnant and I had huge bleeding in the start of my pregnancy , the women on the desk she saw how terrified I am but kept saying me it’s better to wait and go to see your doctor (my doctor was closed that day ) then with really rude attitude she finally accept as . PS: the emergency was totally empty only one women was there waiting Today I called again to take appointment for giving birth (they remind me that I should not give birth here ) the first guy who picked my call he just transferred the call without saying any word , no hallo even , the second women since the start of my call she kept saying in German I cannot understand I cannot understand! And I just said hello , my name is hana nothing else ( in German ) I said sorry my German is not so good and I repeated my sentence and she said again I cannot understand call again and just cut my call !! Ok I am not a native German speaker and maybe I have accent but that’s totally normal and I know that I am talking correct German at least make some effort and talk correct to people !!! Have some manners !!

The staff at the primary care clinic was so friendly and professional, but once I got to the oncology department the staff were bigoted unprofessional and abusive.

My wife had a very strong headache. With "very strong headache" I mean - she couldn't talk, walk normaly. At the reception she answered a lot of questions. We were by family doctor. She had already the referral slip for MRI. They took blood and gave her something that had a little helped. They denied to make the MRI because of missing plausible Reason. They didn't check even the blood pressure. All my wife saw in this Emergency was only indifference and loss of care. How we must be sure that we will live a long healthy life, when the persons who are paid for that don't take reasonable steps to prevent a Death? Shame on german Health System. I recommend to search for another Emergency Point in the City. At Uniklinikum you have a very big chance to die. And they will say - "we didn't know" or another stupid argument. This happened on 28.10.2022. We came at 17:00 and left at 22:00. Besides - they found nothing.

I had a great experience giving birth at UKE. everyone working there was super nice, cooperative and friendly at the registration and at the Kreißaal as well as in the postpartum care. We requested the family room, which became available in few hours post our request ( you do need to keep following up the availability status of the room til you get it though ) For the mom, you need to get a shirt/ dress to give birth in. And pjs for afterwards as well as the bathing supplies For the baby, you will only need to have the go home outfit and maybe a pacifier. All else will be supplied by the hospital. The meals served are really good too. Not the typical tasteless hospital food .. you will need to have some snacks with you for in between the meals especially if you’re planning on breastfeeding. All in all, i had a really good experience and highly recommend the hospital

Waste of time! I got food posioned and waited for hours! Nobody checked me and I had to leave because another patient came and told us she was waiting for 7 hours. I mean this is an emergency, it shouldn't be like that. Aside from all these stuff there was very rude. I was fighting with pain and with the people at the same time. Not even talking about the money I paid for the taxi because I thought I can get help here. I don't know what I am gonna do if I ever have more risky situations like that. This has to be changed.

18 year old friend of mine has been hospitalized due to a tumor. because of a so called "emergency" a vacation had to be cancelled and he didn't even make it into the infirmary. during the operation they managed to injure the liver (which isn't exactly spottet on the head) and he was in a critical state. he died less than a week after the operation and the doctors had the audacity to say "have a nice evening". worst hospital ever. will make sure none of my loved one's ever go there again.

I am a professional who moved here to contribute to uplift industrial activity in my own area. Heard great input from friends on Helios, about English speaking staff, better handling than long and declining German medical system. When registered my wife for birth and checkup at the last stage of pregnancy - and recently visited, the rooms are hot (making the patient more inconvenient), then we requested female doctor/nurse due to our own comfort and values, but instead when the female doctor arrived she ended up giving me lecture to understand their culture, you are in germany, even in your home country there are only Male doctors & Staff (which she doesn't know 60-70% of medical employees are female in my home country). She was straight forward denying the service if we do not agree on the male attendant. We had no other option but to say yes, however, this has been traumatic experience turned from a happy moment. As a Service provider the doctor should be able to provide a relaxing and comfortable environment. And the treatment was not something that couldn't be done alone when requested. It was a one person job, she could have do it herself, but forced to have male attendant to just hand over tissues or so. And even after that told me to expect male attendant regardless you want or not during delivery.. Service providing is the key. highly disappointed.

I could put 0 or -5 if that was possible. I guess 1 star goes to nursing personnel some of whom were nice. My mother was admitted there with stomach cancer and fluids in abdomen supposedly for immune therapy (we know it is a last resort). Doctor (Ali Nuri Hunerliturkoglu) even wasn't fully aware of the diagnosis at the admission. At putting the port for immune therapy/chemotherapy, lung was punctured leading to an infection. Biopsy results were late, hence no promised immune therapy was provided just a general, non-specific chemotherapy, which weakened the patient together with hospital-induced punctured lung and infection to the point of not being able to walk and normally function. No help at all, just prolonging of suffering. To top it off, transportation to pick her up and deliver home was not allowed to approach hospital premises and a lying patient on a rolling bed had to be transported for 10 minutes outside in the cold. Avoid if possible

I had this year three operations in Krefeld hospital.Two of them was not planned one of them was planned.Everything goes smootly.Personal are very friendly doctors also will try to explain everything till the end.Food quality also not that bad like hospital food.My plate was empty always.I had only one small minus the pillow for your head its like a carpet to clean your shoes so tin and not comfy at all 😀 Even this hospital is one hour where i live but anyway i would always choose this hospital and recommendate to others

Awful. Patient Management is closed when it have to work. No response via phone to ask why you must pay specific amount of money and for which services. Huge respect for doctors, but management of clinic is awful and they deserve even less than 1 point out of 5.

After almost 30 hours, they still don’t know when they can perform surgery on my kidney stone. They only gave me 5 glasses of water! When I asked them about my situation and the plan, nobody answered! I’m thirsty, hungry, and in pain from the stone for more than 1 day. This is simply the worst hospital I have ever seen in my life!

Unfortunately but I have a pleasure to have surgery on pancreas cancer here. UK NHS said its noopetatable😬. The rooms 10 stars out of 5🙂, super clean, staff constantly checking on you, everything went smooth and pain free(thanks to epidural and painkillers). I have been sent home when I was ready, no complications and, 7 month out and good so far. Highly recommend, plus beautiful town which I was able to see before surgery.

I, or we, would like to thank the doctors and nurses who looked after and cared for our father and husband from the bottom of our hearts. The situation wasn't easy for us, but everyone always answered our questions openly and honestly, even if they asked the question 20 times. They stood by our side in his and our most difficult hour. The ITS2 is not a ward like any other, but people with heart work there ❤️. Thank you thank you thank you

They are really unfiendly. I am learning German because I live here but my german is not sufficient enough to book medical appointment. If you can't understand me that is okay but you don't have to be rude!

Nurses are kind, the place is clean. You must speak german at least on a minimum level and understand what they say to use the services.

I got a brain surgery in 2017 and stayed for over a week here. I felt well treated, especially by the staff of international nurses and some doctors. I got some complications that I don't know whether they came from the care I got or if I dodged a bullet (6 hours surgery). Follow ups are a pain, emails don't work, phones only, and one has to wait for months for something.l, but the system is the bigger problem. I trust the professionals here, some will even talk English to you if asked. (Sure, don't come to the emergencies if you can be treated elsewhere). The facilities look a bit better than other hospitals in town.

the worst hospital I've been to. I broke my leg and they told me to go at 7 in the morning for the operation and they left me until 8 in the evening without giving me any information, without water. Then they remembered to come and inform me. The next time I was driving with my mother, who had a bypass and her blood pressure was quite high. The doctor asks me if he is dead? does someone have to die for us to go to the hospital? Because we also pay insurance for the doctors.

This is going to be a long story about my terrible experience in the emergency service. An ambulance brought me here at 21:30 with a broken swollen ankle. Since the emergency guy brought me inside and put me in a bed, no one came to me to do the first check-up. I begged 3 "nurses" to at least bring me ice because I am dying of pain. They go and never come back. They didnt give me ice, nor pain killers, they didn't even do a first check-up on me. How professional! especially when I can see them talking to each other, laughing, talking over the phone. The level of ignorance that I saw here is unimaginable. They are lucky that I was in pain otherwise I would have called the police. So around midnight finally someone came to do xray for me. half an hour later someone came to me to explain the severity of the injury, put the cast for me and gave me the crutches. Then he told me a nurse will come to explain everything, show me how to walk with the crutches, bring me outside with a wheelchair and call me a taxi. But no one showed up. I was screaming and no one heard me. At the end, around 02:30 I had to ask a "guest" for help. Luckily he was a nice guy unlike the nurses and stuff here. He helped me to walk outside and waited with me for a taxi that I called! I am waiting to fully recover and then I will see a lawyer about this. I even called them after days to send me the xray because the doctor wants to see them and they ignored my emails and phone calls. 5 hourse in the emergency with a broken ankel. No help, no check-up, no ice, no pain killers. No one helped me to leave and they didnt even call me a taxi!!

Was there at 10:30 PM . They registered quick , took blood and immediately send me to the concerned department. However had to wait 3 hrs before a dr finally addressed me . Really is this how they define emergency?

A tertiary hospital with a lot to offer, successful surgeries and high tech equipments. Problem is the people working in it. It puzzles me why some staff doctors and nurses are incompetent, arrogant, rude and unfriendly.

Disaster! Avoid coming here by all means. Hours and hours waiting when there are no other patients and you are being told just to wait a little bit more! Catastrophic, the worst ever!!!!!!

Accidentally my mother is sick,she is a 3 month visitor,I called 112 , the crew came very fast ,they were very kind, professionally treated my mom and they helped me with language when we reached the hospital , the nurse, receptionist,the Dr all give professional service ,with smile in their face,I stayed almost 8 hours, they were very busy ,they receive now and then emergency sick people.i just can say ,God bless you all the time ,God give you healthy life as you help a sick people under God will.thank you very much to all Ak clinic crew ,l💕💕💕💕

I was here two weeks ago as I cut my finger by accident. It was bleeding A LOT. Dripping onto the ER floor. Nobody cared until I had a panic attack. There was at least one good nurse with empathy. She was young and had black hair. Should have known her name.. The other middle aged nurse would mock me while passing, saying sth like she (obviously me) keeps crying and crying 😒 (with this face haha). I’m sure she thought I could not understand German only by looking at my appearance. Anyway I waited for like at least four hours there. Okay, yes, I was not obviously dying and I knew that, but at least I wish I had known what was going on and all. And the ER was not busy at all. Like four patients before me, I think. When I could finally get the x ray done, the woman in the x ray room was the WORST. My tendon was 100% cut so I could not move my finger. And yet, the incompetent woman tried to force my finger straighten up so hard and it gave me a lot worse pain than the one I had before going into the x ray room. Anyway, in the end I got transferred to St. Georg’s Asklepios and got surgery for re connecting my tendon after a long waiting time. I don’t think my nerves were connected properly as I cannot feel right side of my finger very well. I’m visiting a different hand surgeon at a different praxis. If this symptom persists, I’m getting the check up outside of Germany. Just like one review I have read here, I would rather just die (lol, with a bit of exaggeration) or fly to my home country with better health service if necessary. Even Cambodia had a better hospital, where I had to visit because of anaphylaxis during my travel there.

Very friendly staff overall. I came here to get my booster shot and I was at the wrong building, the security guy showed me where I needed to go. Then at the vaccination facility, the doctors were very helpful and informative.

Do not go here. In our experience there, they did not take our pain seriously. On top of that, they made sexist comments!! I would not recommend this place to anyone for anything.

I have visited Orthopedics department 2 times, really awesome service. Could be better, little more waiting time however currently it is really good, humble staffs and polite in nature.

Negligent in their duties, they don't follow medical guidelines. Many workers are just arogant and would want you soon out of thier way rather than trying to find the cause for your ailment. It's sad they are a university who make helathcare workers of such low quality.

Context: Foreign patient/tourist Lack of signage for foreign patients is what exacerbated this horrible experience not knowing what is the correct entrance, the fact that you can't go any doctor and must go straight to the emergency reception for example (flat fee is also 200 EU which luckily was refunded by my travel insurance) 1 receptionist out of 7 was friendly, rest were horrible to an ill person despite being polite as possible 1 doctor in the emergency ward was pretty careless after dismissing me from the hospital (and was dismissive), not even providing a proper dressed bandage for my wound after removing a drip needle that was never used to give fluids (something usually done for pain or dehydration - I was expecting some for relief but none was given) A trainee had better bedside manners The doctors in the gyni section were absolutely fantastic, explaining everything, being friendly etc. However, nothing was found for the cause of my pain which was distressing and no pain relief was offered even. A traumatic experience for someone traveling alone. I hope this review helps someone in the future. Will never be traveling back to Cologne as the reception to tourists is 99% of the time cold as ice.

First , I can not comment on medical services , but the buildings and the arrangements, the wide variety of specialties and advanced equipment all are amazing. Well organized campus.

My wife gave birth there. This was the only good experience we had in hospitals. I want to give thumbs up for the best team in the world and especially to Frau Hannah. 🙏

Unfortunately, the attitudes of almost all the staff during a recent outpatient trip to emergency were extremely regrettable. I was initially refused any painkiller for hours, despite having a broken bone. I was made to wait 7 hours, more than all the other people who had come in, not all of whom were acute cases. And I was not given a medical report on leaving, which meant I had to make a separate trip back to the hospital to insist on receiving it. I attempted to politely follow this up through normal channels but the response was excessively defensive and factually incorrect. No apology, no points acknowledged. Very disappointing indeed. All I can say is that 80-90% of the staff there were unpleasant, seemed to hate their jobs and made a difficult situation for me and others like me far worse.

Supportive, very friendly staff and fast help. Large site/area needs time to orientate and find your way. Treatment was top and newest available.

Non-professionals, there is no good communication with the patient! If you have a serious problem, it s better to look for another hospital! It takes a very long time for them to respond, and when they do, they are never clear. It seems like they want to get rid of you or respond in a way that makes you give up and look for other doctors or hospitals. Be clearer that you are medical professionals! For station mund und kiefer.

Came with toothpain on sunday,didnt wait too long cca 2 hours, doctor and nurse were very kind,spoke English,helped me with pain,so im happy i came there,just parking is pretty expensive.

The emergency department is just a disaster. Organisational chaos. As a result- hours in a waiting line.

I really hope Google will someday let me give negative score to this place. I had to wait 2 months for an appointment, only to come here and sit in the waiting room for 1.5 hours (and the appointment is for a 2 minute consultation). The level of inefficiency and incompetence is just astonishing