They did not give me the Valium pill before they rolled me into the operating room.
“I thought it was standard practice?” I asked the anesthesiologist in French as he sat on the edge of my rolling hospital bed, inserting the intravenous into my hand – the most excruciating part of the surgical experience.
“It is when the patients are nervous or worried, but you seem just fine,” he replied.
Looks can certainly be deceiving.
Health care in France, like in Canada, is public in the sense that all citizens or legal residents are entitled to basic care free of direct charge. French tax payers pick up the collective bill or at least 70% of it. The other 30% is taken care of by private insurance called Mutuelle if an individual chooses to purchase a plan. Most companies offer their employees group insurance, the cost of which is deducted from the individual’s monthly pay check. If no private insurance is bought, then the patient is responsible for those charges him/herself.
My husband and I pay about 90€ a month for our Mutuelle policy which covers us for 100% of all hospitalization as well as routine checkups, dental and optical health care. This means that when I left the hospital on Thursday afternoon I paid nothing up front.
Of course, a great deal of paper work is required before one enters a French hospital for a non-emergency procedure. At the base of the French health care system is one’s primary-care physician or médecin traitant. This doctor is responsible for the patient’s standard health care as well as giving referrals for any specialists the patient might need to see.
In my case, I had terrible bunions and needed corrective surgery after ten years of walking around in pain. My doctor referred me to an orthopedic surgeon in Bordeaux who performed the operation. I was also required to obtain a letter from my Mutuelle stating that the procedure was within my policy regulations (meaning that my médecin traitant deemed it was necessary). I needed a prescription for special orthopedic shoes which I am wearing right now and will be required to wear for the next month as I hobble around on my heels.
See, in France a patient’s family doctor is the epicenter of the whole health system. If a referral is given for a specialist, a gynecologist or a surgeon, a dermatologist or for a particular procedure like blood work or x-rays, then the national health care system and the complementary Mutuelle will take care of the totality of the charges. If, however, a patient goes directly to a specialist, the national coverage pays around 30% of the charge and most Mutuelle will provide no complementary coverage at all. In this way, family doctors in France wield a great deal of power.
Other than paper work and tedious bureaucratic hoops to jump through, both of which we can expect when living in France, my experience in a French hospital was nothing short of remarkably pleasant. I arrived on Monday evening for an operation scheduled for 8 o’clock the following morning. That evening a smiling nurse brought me a very French meal featuring, comme d’habitude, an entrée, plat, yogurt, fresh fruit, dessert and a mini baguette. No wine, though, which I suppose is as it should be in a hospital; although I half expected to be offered a glass. Even Air France offers its customers complementary wine with their dinner on overseas flights.
Upon my arrival, I was led to a private room with an en suite bath. The hospital itself was a 1960s cubic structure sparsely decorated with lime green and pale yellow accents. Squeaky clean and smelling of Pine-Sol cleaning products, I suspect the bathroom were recently renovated. My real luck, however, was having a host of nurses as kind and as patient as they could possibly have been doting on me throughout my three-day sojourn. Contrary to what we might think about Parisians, the nurses of Bordeaux’s Mutualiste hospital on the 3rd floor southern wing were charismatic and friendly from our first encounter. They gave me the impression that I was their one and only patient. Knowing that I was not a native French speaker, the team of nurses spoke slowly and articulately to ensure that I understood each step and procedure; a gesture for which I am eternally thankful.
I chose to have the surgery in Bordeaux rather than in Paris so that I would be close to my parents-in-law who offered to look after me during my extended recuperation period. Had I stayed in Paris, I most likely would have chosen the orthopedic clinic in the 16ème arrondissement not far from our apartment. Or perhaps the American Hospital of Paris, a reputable institution where I could have freely spoken my mother tongue. But I also chose Bordeaux because one of my sisters-in-law, a doctor, is good friends with the orthopedic surgeon there, so I felt I’d be in capable hands.
At the time of my release from the hospital, I was handed a thick packet of prescriptions, x-rays and referral letters. I was prescribed five different types of medication for various periods of time from 3 days up to a month-long – pain killers, anti-inflammatory medication, stomach protectors, etc. All of these medications are entirely paid for by the national health care and my Mutuelle in the customary 70/30 split. Most of the medications given in France are the generic versions which obviously cost the tax payer a whole lot less than their name-brand counterparts. I must admit that it was a relief not to have to immediately fork over hundreds of dollars for medication to be reimbursed a month later by my insurance. Even in Canada, medication is not included in the health care system, at least not in OHIP (Ontario’s Health Insurance Plan) with which I am familiar.
I am now off my feet for the next five weeks. Having had both my feet operated on at the same time, I find myself quite immobile. A score of acquaintances told me before I decided to have this surgery that they felt no pain at all during their recovery. To be perfectly honest with you, I’m in quite a bit of pain. One of my feet causes me no problem whatever, but the other one, my right foot, is acting up. The surgeon said there’s no real reason why one foot should respond differently than the other. It’s just the luck of the draw. The most difficult adjustment for me is having to sponge bathe and for the first 24 hours after the operation having to pee in a bedpan. The latter is just about as unnatural a process as it comes.
Given that my recuperation time is so lengthy, I am in the care of my beaux-parents down in wine country near Bordeaux. A nurse comes to the house to change my bandages and give me an anti-coagulant shot each evening. My change in situation explains why my posts have been rather irregular for the past ten days and why they will remain so until I get back to Paris. The family’s country house is not equipped with internet and my immobility makes getting to the local town’s internet café slightly problematic. I did prepare a few posts in advance, though, which my husband will publish for me throughout my absence.
I hope you enjoy!