Medically Alone in Paris

It’s common knowledge that France has one of the best health care systems anywhere.  In 2009, the World Health Organization (WHO) declared it the best in the world. Knowing that and considering my late husband experienced French medical care all too frequently, why did I fall apart over having cataract surgery last week? My English-speaking internist recommended the cabinet of renowned ophthalmologists in whom she has confidence. I was able to get an appointment nearly immediately—a good thing because waiting for medical appointments is not good for my nerves or disposition. I sailed into Docteur Caputo’s office in the 16ème near the Trocadéro.  Immediately surveying his walls, there were zero framed diplomas attesting to where he attended school, whether or not he was a real doctor, much less one who was competent to make me see clearly again. Plopping down in his chair, my first question was, “Do you speak English?” Not missing a beat, his response (with a French accent) was, “Yes, my mother’s from New York. She and my Italian father met in the U.S. and they moved to France.” Georges (by now, we were on a first-name basis—or I was) assured me he goes to the U.S. at least twice a year. And yes, he was qualified to operate on me—for that matter, he makes his living constantly doing surgery and has the newest ultrasound equipment. Already, I felt better, if still scoring high on the anxiety scale. Georges explained he’d remove the lens and replace it with a new synthetic one. An Acrosof IQ lens was inserted into the “pocket.”  What a coincidence it’s made in Fort Worth, Texas. I wouldn’t have known this if I hadn’t been handed a patient implant identification card as I was leaving the clinic after the outpatient surgery. The nurse instructed me to always keep it in my wallet because it contains the precise information about my new eye. It’s amazing how the French and most Europeans keep every medical document and the results of all the tests and vaccinations they’ve ever had since they were born.  It’s a complete difference between Europeans and Americans. We’re so used to our primary care doctor keeping our records that when my Paris internist asked me about a surgery I had 20 years ago, I simply couldn’t answer and it was a quasi-major operation. But Nancy, the internist of enormous patience, will simply have to guess about the results. Another difference between French and U.S. medical care is that it’s rarely one-stop shopping unless you’re a patient at the American Hospital of Paris.  In order to prepare for the surgery, I had to go to three different offices in various sections of Paris and Neuilly-sur-Seine.   Then there were the two trips to the pharmacy for pre- and post-surgery medications. One of the other things I learned is unless you have family, surgery when you’re overseas and alone makes you feel vulnerable. When the admissions clerk at the clinic asked for an emergency contact, I gave her the name of my son, who was snowed in and under in Washington, D.C. If there had been a problem, what could he possibly have done except to come and collect my body? I should note this surgery was done seven days after my first meeting with Docteur Caputo and perhaps my thoughts weren’t as organized as they should have been. Prior to the cataract surgery, I surfed the web and then some. It’s a now-routine procedure with few complications.  But there are always some oo-la-las. Another conclusion: if you’re at all language challenged, it’s important to have a doctor who can talk to you in your native language or take a translator. It’s essential patients understand all of the ramifications. During the 35-minute-long procedure, I wanted to know precisely what was taking place, but Georges was having none of it and had draped the surgical area.  If only he and the people who were assisting him would speak up, I would have loved to ask questions. When I was in the recovery room for observation because I’d had local anesthesia, I started firing off what’s and why’s immediately and guess what?  Amazingly, I was asking them in French. The staff responded in English. OK, happily this was a simple surgery. But expats in foreign countries should examine their tolerance level and whether or not they should return home if they’re ill. Patients tend to be nervous and aren’t always listening as well as they should. Line up your friends and support system. Undergoing  these types of procedures are enough to make a calm person nervous. The morning after the surgery, the doctor wanted to check on how the procedure had gone.  He was pleased with the results. I was a bit tired, but was reassured about my vision since it didn’t slow down my tapping away on my BlackBerry. I stuck around the apartment, but that was more because of the sub-zero Celsius weather than because I didn’t feel well. When I went for my second check-up, it was apparent I was the only patient who was alone. After all, this wasn’t a dance where it takes two to tango. I questioned Docteur Caputo if that were always the case, to which he responded I’d have to ask the other patients. On my way out of his office, I told Georges I was writing an article and wasn’t he curious to see what I had to say about my brush with French medicine.  It was only then he gave me his email address. French doctors don’t do that! Hey, merci Georges. First, I can see and second, I realize I can navigate the French medical system and go at it alone. Does this mean I’m a grown-up who can operate nearly anywhere? Please post your comments or questions and let them flow. 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