Friday, August 5, 2011

Cultural Experiences, Category: Medical

There I was, thundering along with progress on the emerging book manuscript--thanks to wonderful comments from K, B and J, and Michael started saying he didn’t feel very good. Tuesday morning, though, when he said he didn’t feel well enough to play boules, I was alarmed. In jest, I asked if he needed to go to the doctor. (He never thinks he does, even when he’s just cut the end of a finger off. True story.) When he said “yes,” and started asking our neighbor about emergency rooms, I went straight into action mode. Once we got to the emergency room, I parked the car and he went in. By the time I got back there (WELL under five minutes), he was nowhere to be seen and they told me to wait. Three hours later, my most polite French and persistence got me back to see him. What a difference from a US emergency room!

First of all, it was dead silent. And I mean silent. Second, there were gurneys lined up perpendicular to a long wall, about twenty of them, each holding a person. The gurneys were so close together their occupants could have touched each other, had they been so inclined. No curtains, no privacy, no talking. Many people, all in various stages of undress and distress. Bags and shoes usually shoved underneath the sheets partially covering them. A man three spots down from Michael got put on a bedpan (totally uncovered) in the midst of the queue of people. Every now and again, orderlies would come, call out someone’s name and take that person away; another orderly would slide a different person-on-gurney into the parking spot. I was the only family member present.

By the time I managed to inveigle myself back there, Michael was back in the queue and had had an ultrasound. He was parked pending results. Eventually, they told us they’d called a specialist and took him to another exam room. I waited in the hallway outside. Family members are not a part of this system, at all. We waited (him on his gurney, me trying to stay out of the way), parked in a hallway. Later, we figured out that the CT scan was ordered about 11:50 a.m. and the technicians were going to lunch at noon, so without really knowing or understanding what was going on, we waited to be taken to the scan until about 1:35. Then, back to the gurney parking lot (in an annex in an open room this time, as all the hallways spots were filled) until the ER doc and surgeon came and said that immediate surgery was indicated. A number of the nearby gurneys were interested in the conversation and one told us that our guy is a very good surgeon. They took Michael then and there for prep and surgery. Someone eventually told me where I could wait. Three and a half hours later, my questions got me the information that the surgery was over and he’d be in recovery for a while, and then be delivered to the hospital room. I was taken to the room to wait. (The wrong place first, then someone took pity on me and told me no one was ever permitted to wait where I was, and found a more correct place for me.)

By the time Michael arrived, he was awake and relatively cheerful. No information about the surgery at all; by asking (over and over, actually), a nurse finally took a look and told me that the surgery had been done laparoscopically, and no large incision had been necessary. It was the next morning before we saw the surgeon and learned the full story: the appendix had burst and infection set in. Five days in the hospital (at least) for IV antibiotics.

The hospital experience is as different from the US as was the emergency room. Like the ER, there’s very little technology in the room. Michael’s quite nice single room has an adjustable electric hospital bed, a desk, a table, a TV, a padded wheelchair and a bathroom. He came complete with an IV pole. No computer. No monitors. No id bracelet. (No HIPAA here!) Also, no air conditioning. The hallways seem to have some cooling going on, but the rooms all have open windows with operating louvers, so we can adjust them as the sun moves around. It’s warm at night in here, and sometimes during the day, too. Michael has not been asked his name or birthdate since the ER. Like the best restaurants, there is a rigid hierarchy of uniforms indicating status and role: doctors in all white, nurses white with maroon (color of blood??) edging, food and linens staff in green, cleaning staff in yellow. All the staff come to the hospital in their street clothes and change here.

Aside from the quiet and almost no technology, the biggest difference between our hospital experiences at home and here is that they seem to believe in the healing power of quiet and sleep. There have been nights with only one interruption, though the night after the surgery had two or three (seems sensible to me). Help is available promptly if requested, but other than that, it’s just us in the quiet room, and the heat. I could use a bit more coolth, even if it was just delivered by a fan. (Those are considered unhealthy and unhygienic, as far as I can tell.)

The surgeon’s office is on our floor, and his secretary has been invaluable in sorting out all the logistics and bureaucracy. Most of the staff here are intrigued by “les Americanes” and have been obliging, the cleaning staff especially. They brought a rollaway bed so I could stay in the room; family are permitted here, but only to be seen and not heard. In the beginning if I asked a question, the nurses were offended and the doctor visibly taken aback. Mostly, they humored me by answering. The surgeon speaks better English than I speak French, so we communicate in a mixture of languages, and he’s set the tone for the others by being accessible, open to both of our questions and willing to explain, even though it seems to be the case that asking questions makes us quite an aberration.

Michael hasn’t had anything but liquids yet, so it’s hard to tell about the food. Thanks to my pals on the food and linen staff, I got a leftover dinner last night that had been earmarked for a patient on a restricted diet who had left. It was revolting. On the other hand, the breakfast appears to be free to all who are here, and I get one every day: hot chocolate, a hard roll and great butter. The cafeteria lasagna I had for lunch today was ok, not great. I get a “family” dinner tonight, so we’ll see what that brings.

This is hard. It’s stressful, Michael still has tubes coming out of him, the language is a stretch, the bureaucracy is complex (that’s a three-page story all of its own), we don’t really understand the system and we’re wrestling with changing airplane tickets in high season. The help and support we’re getting from, well, everyone, is sustaining. I don’t know where we’d be without it. Now, it’s time to rest some more. Thanks for all who’ve been helping and sending love and caring across the miles.