French medical care: Formidable!

John Gagnon

June 02, 1993|By John Gagnon

IT WAS early morning, just after 2 o'clock. I had recently arrived in Tours to start my sabbatical. I knew only enough French to scan a newspaper and order a meal. My wife, fluent in French, was away.

A pain of extraordinary vividness exploded up my abdomen on the left side. I knew I had to obtain immediate medical help.

I was frightened and disoriented as I looked through the information sheets provided for American students seeking local health care. These were in French and in small type.

With increasingly blurred vision, I called a number on the list with a nearby address.

A young woman, a doctor, answered the phone. I somehow communicated that I was in deep trouble, and she responded to the pain and fear in my voice.

With my minimal French, I couldn't be certain, but I understood her to say she would be right over. She arrived within 20 minutes. After a quick examination, she called an ambulance, which came in what seemed only a few minutes.

By this time, all of my French had deserted me. I was taken to the emergency room of a nearby hospital, where the staff quickly decided that extensive surgery was needed.

They were not well enough equipped to do it, so I was moved immediately to another hospital where specialists had been alerted.

After a second ambulance ride, I found myself in a second emergency room, where I asked that someone contact my wife, who was arriving on a flight from the United States that morning.

I was gurneyed into an operating room, where a pleasant-faced woman looked down at me and said in English, "I am Dr. Robin, the anesthesiologist."

I awoke at about 4 p.m. in a single room with a tube down my nose and a metal tree above me with bottles and plastic bags of various sizes dripping into the intravenous needles in my wrist and neck.

Down the center of my belly I could see an incision about eight to nine inches long, held together by about 40 neat black stitches.

My wife was sitting across the room; she had received a message to call the hospital when her plane landed.

She told me my appendix had burst, probably two or three days before the pain that prompted me to call for help.

I spent 11 days in the hospital. During that time, the tubes and drains were removed, the intravenous medications changed and then stopped, and finally the stitches were removed.

I was washed. My bed clothing was changed when necessary. No intravenous bottle was ever empty before being changed, no needle ever missed a vein, no call for assistance went unanswered.

My treatment did not end when I left the hospital. A nurse visited our home daily for 10 days to make sure the incision was healing properly and to give me shots of anticoagulants.

This is not a particularly remarkable medical tale. But to an American eye, there are some oddities.

A doctor made a house call in the middle of the night to someone who was not her patient. No one asked whether I had health insurance until well after the operation. My hospital stay was much longer than it would have been for a similar procedure in the United States.

The nursing staff was not only skilled, but deeply caring. The surgery, all of the medical professionals, medications and the hospital stay cost my insurance company about $6,500.

The only expenses I paid beyond that bill were for the visiting nurse, one ambulance trip and the post-hospital medications.

I have yet to see a bill from the young woman who came in the middle of the night.

My wife called to thank her for saving my life. When asked why she came, she said: "Why would I not come? It's my job."

The American health care system touts itself as the best and most advanced in the world, but would I have fared so well had these events happened in the United States?

It is likely that no physician would have come in the night, no hospital would have admitted me without determining first whether I could pay and no hospital would have transferred a valuable paying customer to another hospital where a more skilled team was available.

Even if I had survived the surgery, I do not think a similar hospital stay in the U.S. would have been as uncomplicated and -- for want of a better word for such a terrible experience -- blissful. And doubtless the cost of survival would have been in the tens of thousands of dollars.

Perhaps I was just lucky, and more knowledgeable observers may find statistical and anecdotal evidence of the incompetence of socialist French medicine.

What I do know is that I am alive and that there is more to be learned from the French than lessons in culture and good food and drink. We ought to study how they deliver responsive, skilled, humane and economical health care.

John Gagnon is professor of sociology at the State University of New York at Stony Brook.

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