Sheryl comes downstairs from the attic bedroom and says, “Jerry is sick, his stomach hurts, he hasn’t slept all night. I think he needs to see a doctor.”
It’s 10:00 a.m. on a Sunday. There’s a doctor on duty every weekend, as there is an open pharmacy and at least one boulangerie—so the French are never without a doctor, medicine, or fresh bread. The doctor’s name and phone number are printed in the weekend edition of the local newspaper, as is the pharmacy. The problem is, I don’t have the local newspaper, and even if I did, I wouldn’t know where to look for the name and number. Anyone else, I’d give him a Tums and encourage him to wait until they returned to the U.S.—or at least till Monday. But I can’t do that with Jerry, so I do the only thing I can: I call Madame P. Monsieur answers the phone and I explain, “Mon ami est malade. C’est necessaire le docteur.”
“OK. D’accord.” That’s all he says, but it’s enough to assure me the world is right.
Thirty minutes later, there’s a knock on the door. A short, slightly balding man who looks like a doctor and says he’s a doctor—“Docteur L”— shakes my hand and says, “Bonjour.” I can tell he’s miffed. I’m wearing my I-have-nothing-to-do-but-lounge-around-the-house-on-a-Sunday-morning-pants, holding a steaming cup of coffee and smiling, which is clearly what he thinks he ought to be doing, at his home, not catering to me.
“Pas moi,” I say. Not me. “Mon ami,” and I lead him up the stairs. “Parlez vous anglais?” I ask, hopefully.
“Non.”
Jerry and Sheryl speak no French. It becomes Donna’s and my job to translate. I figure Jerry’s lucky if he gets out of this without a hysterectomy. Donna tells the doctor about Jerry’s heart. “Le coeur est très malade. Il a beaucoup de médicaments—il a eu cinq crises cardiaque.” The doctor makes that deep sucking sound that tells me he understands, and that it’s serious. He asks lots of questions, which to the best of our collective abilities Sheryl, Donna, and I try to answer. It’s harder than the GRE. I have no idea how well we’ve done, what he understands, or for that matter, what we even said. He gives up on us and starts on Jerry. He probes, pushes, and squeezes. Jerry squawks. He repeats everything and Jerry squawks again, louder, clearly in pain. The doctor listens to Jerry’s heart and lungs, writes things down, turns Jerry over, and does it again from the back, all the while making those sucking sounds and saying “bon” and “oui” to someone other than us.
He spends twenty-five minutes tapping, pushing, probing, squeezing, pinching, listening to Jerry front and back, periodically saying “bon” or “oui” to himself. Jerry accompanies him with “oh” and “ow” and an occasional howl. Finally, the doctor looks at me and begins a long, detailed diagnosis. Then he gives up and talks to Donna. “Appendicite, peut-être,” and “hôpital,” are the two things I understand. He takes out his cell phone and makes the call.
Madame P’s youngest son, Henri, is the patron of the largest ambulance and taxi service in Loscoat. The call will go to him.
Sure enough, ten minutes later, Henri and Louis arrive in a shiny new ambulance. Henri hops out of the driver’s side and Louis out the other, and we all shake hands: Henri and me, Henri and the doctor, Louis and me, Louis and the doctor. Sheryl comes down the stairs, and Henri shakes her hand, then Louis shakes her hand, then both of them shake Donna’s. When there’s no one left who hasn’t been shaken, we go upstairs to see Jerry, who looks like he’s feeling neglected. Henri shakes his hand. Louis shakes his hand, and the doctor begins his long diagnosis again. Henri translates the French to English for Jerry and Sheryl and Donna and me and translates the English to French for the doctor. The conclusion is the same in both languages: “Appendicite, peut-être,” and “hôpital.” The doctor writes something on a pad and hands the paper to Henri. He shakes Henri’s hand, Louis’s hand, Jerry’s, Sheryl’s, Donna’s, and mine.
I walk him down the stairs to his car, a not very fancy Renault. I shake his hand and thank him profusely, “Merci, merci, merci,” and wish him a “bon dimanche.” It’s the last any of us see or hear from him. In France, apparently, this is just part of a doctor’s job. C’est normal.
I go back in the house and watch as Henri and Louis help Jerry down the stairs. Jerry’s six foot two and weighs over two hundred pounds—moving him isn’t easy. If he falls, stopping him will be even harder. They get him to the ground floor and sit him on a gurney, lay him down, strap him in, wheel him out, and lift him into the ambulance. Sheryl jumps in and rides with him. Donna and I follow in the car.
Henri gets on the N165 heading south, to Quimper, the same hospital where I met Jacques and visited Madame P. I’m starting to feel like a regular. I’ve now been to this hospital more than I’ve been to Kaiser in Oakland, where I’m actually a member.
We arrive at the emergency room at eleven fifteen. The intake person, a young blonde nurse, greets us with clipboard in hand, and I wonder how we’re ever going to get through, given the required documentation we’ll need and in all likelihood, don’t have.
The nurse asks Jerry, “Votre nom?” and “Votre age?” That’s it. Two questions, and he’s in. There’s no signing away of his house, retirement, wife, or kids; no questions about insurance, money, bonds, deeds, stock, mortgages, or credit cards. It’s like: ‘you’re sick, you need help, you’re in the right place. Don’t worry.’
A thin, buzz-cut, sportif-looking doctor arrives and asks about Jerry’s medical history. Henri, who has stayed with us, translates for Sheryl. Sheryl tells Henri, and Henri tells the doctor, “He’s had five heart attacks and a stroke.” The doctor asks what medications Jerry is taking. Sheryl understands the question and tells him. When she stops, the doctor says something to Henri, who explains, “Jerry is taking a blood thinner. Coumadin. It is not possible to operate or do anything invasive until his blood stabilizes and he has regained the ability to clot.”
We nod in comprehension. The doctor shakes everyone’s hand and leaves to talk to the intake nurse. The intake nurse says, “Oui . . . Oui . . . Bon . . . ” picks up the phone and makes a call. Two orderlies arrive in two minutes and wheel Jerry away. Sheryl kisses Henri four times, shakes both his hands, says “Merci, merci,” and follows Jerry to wherever they’re taking him.
Henri looks at me and shrugs. “C’est normal.”
I believe him. He shakes my hand, hands me his card with his cell phone number, and says, “If there’s a problem, call me,” and he leaves to help the next person.
I walk to the nurse and ask for Jerry’s room number. “Quel numero est le chambre?”
She gives it to me and says, “Mais ce n’est pas possible de lui rendre visite maintenant.” You can’t visit him now.
I want to argue with her, but I don’t know how.
On the way out, I see it is 12:15. In two hours and fifteen minutes, a doctor has been called, a house visit made, a diagnosis given; an ambulance called, a thirty-kilometer ride, admittance to the hospital, and a room. All with no money being exchanged—or even discussed—and on a Sunday morning. It costs more and takes longer to eat lunch at the 2nd Avenue Deli.
Donna and I drive back to the house and wait for Sheryl’s call. She calls at two o’clock and tells us Jerry has his own room, and she’s staying with him. She calls at five to say they’ve begun testing and examining to determine what’s wrong. At seven, she says they think it is appendicitis, but they can’t be sure without opening him, and they can’t do that until his blood thickens. All everyone can do is wait.
From my visits to Monsieur and Madame P, I know French hospitals do not normally allow wives or husbands or family members to spend the night with a patient in a hospital room. For them, it’s another person to answer to and take care of, which means more work. Sheryl, however, is not normal or French. At five foot one inch, one hundred and five pounds, she’s cute as a canary and steely as bridge cable. She is not going to sway, let alone budge, and speaking no French, she conveys it. Do not mess with me. In the U.S., they would welcome her, toler
ate her, or arrest her. In France, they ignore her, which means no one brings her a comfortable chair, blanket, or food. The plan is to starve her out.
Sheryl calls the next day at nine in the morning to say they operated on Jerry the previous night. His blood stabilized around midnight, and they opened him, found the problem—a blockage in his intestine—removed about a foot of it, and sewed him up. He’s resting, and she’s eating a croissant that one of the nurses snuck her.
In the U.S., that would be the end of it. He’d be walking that day and home the next or the day after. In France, it’s just the beginning. In the U.S., surgery heals—so get up and out of bed. You’re better, quit lollygagging about. In France, surgery hurts. It’s an invasion—something the French know more about than Americans. Remember, the Third Republic: 1871, 1914, and 1940! After you’re invaded, you need time to heal, recoup, and rebuild your strength, because one thing is certain: the next invasion isn’t far away.
Meanwhile, by the third day, Sheryl has moved into the hospital. She has her suitcase, books, and is sleeping there. Instead of despising her, the doctors and nurses admire her spunk, her willful flouting of authority, even though the authority she is willfully flouting is theirs. It doesn’t seem to matter. On the second day, an orderly brings her a blanket and pillow. On the third day, a nurse wheels in a cot. The fourth day, they are bringing two food trays to the room. The fifth day, two menus, and when Jerry tells the nurses about the special diet Sheryl’s transplant medications require, they start bringing her specially prepared foods.
By the end of the first week, Sheryl is living with Françoise, the chief nurse taking care of Jerry. Françoise drives Sheryl to the hospital early in the morning and drives her home late at night, including the days she isn’t working. She shops and prepares special meals for Sheryl according to her medical and dietary needs. Sheryl lives with Françoise for six nights. Françoise speaks no English, Sheryl no French. They become the best of friends.
After ten days, the hospital is ready to discharge Jerry
—to Bénodet or Roscoff, or some other beachy paradise “pour récupération.”
Jerry says, “No.”
I tell him about visiting Madame P and how lovely it is.
Jerry says, “I want to go home.”
I appeal to the shopper in him. “Tourists are spending thousands of euros a week to stay there. It’s a deal, Jerry . . . a fully paid vacation—room and board.” This is a guy who listens to four-hour spiels about time-shares in Reno to get a free night in Sacramento.
He says, “No,” again.
I try the humanitarian approach. “Sheryl needs the rest. Do it for her. Hell, do it for me. Sign up and I’ll go if you don’t want to—as long as nothing invasive is required.”
“I want to go home.”
I understand, and I don’t. Everyone wants to be home, in their own bed, when they’re ill. But he’s better now—and still in Brittany. He’ll be home soon and long enough. Stay, enjoy the gift, the views, weather, sites, and food; take the rest your body needs to heal—but Jerry is adamant, and as much as Sheryl wants to stay, she knows they’re leaving. It’s part of their agreement: the one who is ill, if and when possible, makes the decisions.
Sheryl begins calling the airlines. Watching her is like watching a trader trying to close a deal: talking, threatening, cajoling, crying, yelling, until she convinces United Airlines to change their flight without paying their usual penalty.
On the twelfth day, Jerry is discharged without paying a sou, leaving a credit card, fingerprint, or body part—other than a foot of his intestine. He goes home healthy, almost healed, and not broke, in debt, or destitute. And he and Sheryl have a new friend, Françoise, who visits them two years later and lives with them for five weeks.
When the bill finally arrives in the U.S., Jerry’s insurance pays it. The total is in the low thousands, about what he’d pay for an emergency room visit in the U.S. or a week for two in Cancun.
10 Things I’ve Learned about Health Care in France
1. Don’t get sick or go to the hospital on a weekend or holiday, during the summer or a heat spell, probably not even during midi, and definitely not in August, when it’s hot, there’s no air conditioning, most of the doctors are on vacation, and those who are on duty wish they were not. In 2003, fifteen thousand people baked to death in their apartments and hospitals during a July-August heat wave. If I am unlucky enough to go to the hospital during one of those times, I want to appear to be very ill. It’s the best chance I’ll have of seeing a doctor and getting treated. Think “triage”—a French word, after all.
2. Mental Health Services: They are great if you’re standing on the street screaming at passersby or yelling at yourself, or wake up thinking you’re Napoleon. You’ll be certified nuts, sent to a hospital, see a psychiatrist, and get drugs and therapy, all of it covered and reimbursed by Sécurité Sociale. The same is true with school-age kids with serious mental and behavioral problems: covered and reimbursed by Sécurité Sociale. But if you wake up feeling blue about your life, spouse, job, or kids, or you want to quit smoking or drinking, there are not many neighborhood counselors or rehab centers, especially in non-urban areas, and if you do locate one and utilize the services, in all likelihood you won’t be reimbursed. The French attitude toward mental anguish is like the Anglo-Saxon attitude toward physical pain: suck it up—and French people do lots of sucking it up. France has the highest consumption of wine and spirits in Western Europe. Unless you’re a kid or certifiably crazy, it’s the mental-health-from-a-bottle treatment plan, supplemented by pills and visits to the local priest.
3. Dentistry: French teeth look more and more like English teeth. Enough said.
4. Disability: If you’re ambulatory and not too far below the intelligence norm, you’re in luck. French services and supports are great. When Monsieur P was diagnosed with emphysema, the system went into action. He received a stipend to live on, home assistants to do his laundry, shop, and clean house; a visiting nurse on a regular basis; oxygen tanks delivered and replaced as needed; and when it became too difficult for him to climb the stairs with his oxygen tank, the state installed an electronic chair to carry him up the narrow, curving staircase to his second-floor bedroom and bath. But . . . If you’re not ambulatory or are seriously below the official intelligence norm, there’s very little support, encouragement—or convenience—to be or become independent. There are a lack of handrails, public benches and toilets, elevators, and powered wheelchairs. This, plus narrow streets, lack of sidewalks, cobblestones, speeding cars, old houses, and lots of stairs, make it not an easy place to be disabled and live an independent life. For that, I’m thankful for the U.S., especially Berkeley, California, and the San Francisco Bay Area, where Independence with a capital “I” is the goal.
5. Senior Services: If you’re ambulatory, semi-compos mentis, have money and a large family living nearby who actually like you, you’re OK. If not, see Disability, above.
6. General Health: As everywhere, French people are paying more for medical services and insurance and getting less. Still, they have an affordable, universal health care system that covers 100 percent of the legal residents in France for hospitalization, doctor visits, home-health care, and non-medical support frills like cooking, shopping, cleaning, and driving; prescription drugs and lab tests; nontraditional and non-Western medicine; posthospital recuperation; choice of doctors; ambulance and emergency room coverage; pre- and postnatal care, including fully paid family leave for mothers and fathers before and after a baby is born; stipends for having kids and subsidized day care for kids under two; vision allowances; hearing aids; and prosthetics. The United Nation’s World Health Organization ranks the French medical system number one in the world. The U.S. ranks thirty-seventh. The U.S. ranks thirty-eighth in the world for longevity. France ranks tenth—imagine where they’d be if they had air conditioning!
7. The four cardinal rules of French medical services are also
the rules for French life. Rule Number One: No physical pain. If you feel it, treat it. If you think you feel it, treat it. If maybe, sometime down the road you could possibly feel it, treat it. Suffering in France is reserved for the mind, the soul, the spirit, the metaphysical and metaphorical heart; it’s for poetry and philosophers and chanteuses, not for the body. For the body, there’s Merck and Johnson & Johnson . . . When I go to the pharmacy for Monsieur or Madame, I always return with a shopping bag full of painkillers. The first day I visited Jerry after his operation, he was lying in bed, happy and drowsy, pumping away at his morphine dispenser, oblivious to everything around him except his thumb. Physical pain is a no-no. Mental and spiritual pain are inherent to life.
8. Rule Number Two: No hunger. Food is ubiquitous, plentiful, and good. It smells good, looks good, and tastes good—and there are seconds, thirds, fourths, and fifths if you want them. Every time I visit someone in the hospital, the food tray is there and something’s always on it to eat and drink. When patients are ready, they are given a daily menu offering choices of poisson, viande, laits, and poulet for midi. Some have wine: white, red, or rosé. Others have two desserts. The lactose tolerant have cheese. It’s like Air France, except here the seats fully recline and the only turbulent air is your own.
9. Rule Number Three: Privacy and politesse. Nurses and doctors and orderlies are polite. They address you as an adult, “Madame P” or “Monsieur K,” not some infantilized Annie, Bobby, or Jerry. They shake hands with the guests-cum-patients and say, bonjour, when they enter the room and au revoir or à bientôt or à tout à l’heure when they leave; s’il vous plaît, before they touch you, and merci when they’re done. They knock before they enter, and wait to hear entrez before they do. French people value their privacy and do not like surprises. Hence, all the doors are closed. No one—not even a doctor—can walk down the hall and witness someone’s private moments.
(Not Quite) Mastering the Art of French Living Page 20