25.4.13

Cross Cultural Medicine

I have been meaning to write a blog about my experience with the French medical system for quite some time now.  You've most likely gotten little glimpses of our experiences along the way, like the fact that our team bought and administered its own vaccinations...Being in general young healthy adults who also happen to be doctors, we tend in general to be able to avoid a country's medical system.  At Tenwek, we often diagnosed and treated ourselves because illnesses were small and it was easy to get the medicines we needed from the hospital pharmacy.  So we never had to "go to the doctor" or figure out the health care system, except in the sense of working in it.  :)  Which counts for something, but of course being a patient is much different.

It likely would have gone the same way in France...again, young healthy adults/physicians who in general don't need to see a doctor and if they get sick can usually diagnose themselves.  Even our kids fall into this category...a friend of our gave us the "developmental stages" questionnaires to give our kids, and Alyssa and John brought otoscopes/ophthalmoscopes for looking into little ears.  But for the fact that I got pregnant.  Since I am not a proponent of home births, in the end I needed to establish care with a French midwife and spend two days in a French hospital for the birth of Baby Tobias.

Just as well.  It was a good language learning experience for me, and also a fascinating look into another developed world's health care system.  I can in some ways see how health care costs are kept down.  Every month, and only every month, I went to visit my midwife.  I paid her 21 euros for my visit.  She had no nurse or receptionist...I would simply wait outside her door and she would come get me when she was ready.  She would answer the phone on her desk when it rang.  She took my vital signs herself and charted everything in the computer.  Not such a bad system, it seems.

The hospital experience was similar to being in a US hospital.  Except of course for the fact that everyone spoke to me in French.  Some interesting differences:

1.  Breakfast.  The French are known for their very minimal breakfasts.  I literally received a tray of bread and water, no joke.  There was also jelly for the bread and a tea bag for the water, but wow.  The first morning I texted Eric to tell him to bring this postpartum mama more food!

2.  Baths.  Every morning, a nurse assistant came to get me and Toby for his bath.  Daily baths, performed in a very particular ritual which involved submersion up to the neck (umbilical cord be darned) and sticking cotton swabs in his ears and nostrils.  50% of my French comprehension comes from context and I'm sure the nurse thought I was a terrible third time mom since I couldn't figure out how she wanted me to give my kid a bath.  Wait, you want me to do WHAT?!

3.  Linens.  I was expected to bring all my own clothing, and clothes for Toby, too.  I delivered in a hospital gown but no one ever gave me another (and if you've had a baby you know that you do NOT want to wear that same gown after the delivery).  Before I even delivered, the nurse asked Eric for Toby's clothes.  All I had brought was a onesie and a little going home PJ outfit, plus some socks and a random hat.  She incredulously asked if that was it.  Um, yes?  In the US, onesies, blankets, hats, etc are all provided.  They put every article of clothing on him after he was born and asked if we had anything warmer, so Eric had to bring him extra clothes the next day (also, he was not "allowed" to wear the same clothes after his daily bath!).  For me, I never found a towel to use in the bathroom and dried off after my shower with an extra blanket.  Was I supposed to bring a towel?

4.  Meds.  Every night the nurse would give me a pillbox with the next day's meds.  I was expected to remember and take them myself.  There was no UPC code on my bracelet, no one confirmed my birth date before giving me tylenol, etc.  Rather...freeing, actually.

In the end, the differences were not a big deal, although it was still nice to come home to my own bed and family.  The cross cultural differences were not big but they were present, and constant conversation in a different language was draining for me.  Hopefully I got some good education out of the experience.

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